Transfusion-Transmitted Klebsiella pneumoniae Fatalities, 1995 to 2004

Niu, Manette T.; Knippen, Maureen; Simmons, Lois; Holness, Leslie

doi:10.1016/j.tmrv.2005.11.007

Cited by 34 publications

(41 citation statements)

References 51 publications

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“…Klebsiella spp. were the most commonly reported Gram-negative organisms (21). As mentioned above, we observed that the PGD immunoassay revealed some strain-dependent differences, especially regarding the efficiencies of detection of different K. pneumoniae and E. coli strains.…”

Section: Discussionsupporting

confidence: 52%

The Pan Genera Detection Immunoassay: a Novel Point-of-Issue Method for Detection of Bacterial Contamination in Platelet Concentrates

et al. 2010

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Bacterial contamination of platelet concentrates (PCs) still represents an ongoing risk in transfusiontransmitted sepsis. Recently the Pan Genera Detection (PGD) system was developed and FDA licensed for screening of bacterial contamination of PCs directly prior to transfusion. The test principle is based on the immunological detection of lipopolysaccharide (for Gram-negative bacteria) or lipoteichoic acid (for Grampositive bacteria). In the present study we analyzed the applicability of this method with regard to detection limit, practicability, implementation, and performance. PCs were spiked with Staphylococcus aureus, Bacillus subtilis, and five different Klebsiella pneumoniae strains, as well as eight different Escherichia coli strains. The presence of bacteria was assessed by the PGD immunoassay, and bacteria were enumerated by plating cultures. Application of the PGD immunoassay showed that it is a rapid test with a short hands-on time for sample processing and no demand for special technical equipment and instrument operation. The lower detection limits of the assay for Gram-positive bacteria showed a good agreement with the manufacturer's specifications (8.2 ؋ 10 3 to 5.5 ؋ 10 4 CFU/ml). For some strains of K. pneumoniae and E. coli, the PGD test showed analytical sensitivities (>10 6 CFU/ml) that were divergent from the designated values (K. pneumoniae, 2.0 ؋ 10 4 CFU/ml; E. coli, 2.8 ؋ 10 4 CFU/ml). Result interpretation is sometimes difficult due to very faint bands. In conclusion, our study demonstrates that the PGD immunoassay is an easy-to-perform bedside test for the detection of bacterial contamination in PCs. However, to date there are some shortcomings in the interpretation of results and in the detection limits for some strains of Gram-negative bacteria.

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Section: Discussionsupporting

confidence: 52%

The Pan Genera Detection Immunoassay: a Novel Point-of-Issue Method for Detection of Bacterial Contamination in Platelet Concentrates

et al. 2010

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“…Há vários casos relatados associando sepse após infusão plaquetária 1,18,19,[21][22][23][24] . Uma reação transfusional é caracterizada através de sinais e sintomas tais como: febre (com aumento de temperatura de 1 a 2°C), calafrios, tremores, hipotensão, ruborização, náusea, vômitos e choque 25 .…”

Section: Métodos Resultadosunclassified

“…Embora o risco de infecção viral tenha diminuído consideravelmente nos últimos anos, a contaminação bacteriana de concentrados plaquetários (CPs) é, atualmente, o maior perigo remanescente de infecção em transfusões sanguíneas 1,2 . Mesmo que o número de bactérias presentes na bolsa no momento da coleta seja pequeno, a estocagem destes hemocomponentes a uma temperatura entre 20-24°C por 5-7 dias facilita a replicação bacteriana 3,4 .…”

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“…A transfusão de bolsas de CPs constitui um importante suporte no tratamento de pacientes, especialmente nas unidades de hematologiaoncologia 1 . Por isso há um grande risco na transfusão de produtos sanguíneos contaminados, uma vez que a maioria dos receptores são pacientes imunossupr imidos, mai s susceptívei s ao desenvolvimento de complicações clínicas agudas o u retardadas 6,7 .…”

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Contaminação bacteriana em concentrados plaquetários: identificação, perfil de sensibilidade aos antimicrobianos e sepse associada à transfusão

Martini

Kempfer

Rodrigues

et al. 2010

Rev. Soc. Bras. Med. Trop.

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RESUMOIntrodução: Devido à sepse bacteriana associada à transfusão de concentrados plaquetários (CPs) ter sérias consequências clínicas para os pacientes, alguns procedimentos têm sido incorporados na preparação e no controle de qualidade dos componentes sanguíneos para reduzir o risco da contaminação bacteriana. Este artigo descreve a prevalência da contaminação bacteriana dos CPs que foram transfundidos, o espectro bacteriano detectado com seu perfil de sensibilidade aos antimicrobianos e as reações transfusionais nos receptores. Métodos: Um total de 292 CPs (278 randômicos e 14 por aférese), proveniente do Hemocentro do Estado do Rio Grande do Sul (HEMORGS) de Santa Maria foi testado. As quantidades de 100µL e 200µL foram coletadas da porção tubular da bolsa de plaquetas e semeadas utilizando dois tipos de metodologias. Resultados: Em cinco unidades(1,7%; 5/292) foram isoladas bactérias pela metodologia qualitativa e apenas uma pela quantitativa. Staphylococcus epidermidis foi o microrganismo identificado em todas as amostras. Dois pacientes apresentaram sepse associada à transfusão com desfecho fatal. Conclusões: A contaminação bacteriana pelas transfusões de CPs constitui-se num importante problema de saúde pública devido a sua associação com altas taxas de morbidade e mortalidade. Neste estudo, somente microrganismos gram-positivos foram isolados sendo que nenhuma amostra obtida por aférese apresentou contaminação. Palavras-chaves: Concentrados plaquetários. Contaminação bacteriana. Sepse. Staphylococcus epidermidis. ABSTRACTIntroduction: Bacterial sepsis associated with the transfusion of platelet concentrates (PCs) results in serious clinical implications for patients. Given these implications, certain procedures have been integrated into the preparation and quality control of blood components to reduce the risk of bacterial contamination. This article describes the prevalence of bacterial contamination on transfused PCs, the bacterial spectrum detected and their antimicrobial susceptibility profile and transfusion reactions in receptors. Methods: A total of 292 PCs (278 random and 14 per apheresis) from the Blood Center of the State of Rio Grande do Sul (HEMORGS), located in the city of Santa Maria, were tested. Quantities of 100µL and 200µL were collected from platelet bag tubing and seeded using two methodologies. Results: Using the qualitative methodology, bacteria were isolated in five units (1.7%; 5/292), while only one was isolated using the quantitative methodology. Staphylococcus epidermidis was the microorganism identified in all samples. Two patients died of transfusion-related sepsis. Conclusions: Bacterial contamination due to PC transfusion is considered a major public health problem due to its association with high rates of morbidity and mortality. In this study only gram-positive microorganisms were isolated and none of the samples obtained by apheresis presented contamination.

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“…Different reports estimate its rate at 1:250,000 transfusions; the relevant sepsis mortality rate ranges 58 -70% (5). During nine years, FDA registered 25 fatalities due to transfusion of contaminated red blood cell concentrate (6). Thus, the mortality risk is estimated at 13:1,000,000 red blood cell concentrate transfusions (7).…”

Section: Bacterial Infections Transmitted With Red Blood Cell Concentmentioning

confidence: 99%

Transfusion-Associated Bacterial Sepsis

Korsak¹

2012

Severe Sepsis and Septic Shock - Understanding a Serious Killer

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Transfusion-Transmitted Klebsiella pneumoniae Fatalities, 1995 to 2004

Cited by 34 publications

References 51 publications

The Pan Genera Detection Immunoassay: a Novel Point-of-Issue Method for Detection of Bacterial Contamination in Platelet Concentrates

The Pan Genera Detection Immunoassay: a Novel Point-of-Issue Method for Detection of Bacterial Contamination in Platelet Concentrates

Contaminação bacteriana em concentrados plaquetários: identificação, perfil de sensibilidade aos antimicrobianos e sepse associada à transfusão

Transfusion-Associated Bacterial Sepsis

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