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7 - Bacterial contamination in blood and blood components

from Section 1 - Agents

Published online by Cambridge University Press:  12 January 2010

By
Carl P. McDonald ,
M. A. Blajchman  and
Brian C. Dow
Edited by
John A. J. Barbara ,
Fiona A. M. Regan  and
Marcela Contreras
Carl P. McDonald
Affiliation:
Head of Bacteriology, NHS Blood and Transplant Colindale, London, UK
M. A. Blajchman
Affiliation:
Canadian Blood Services and McMaster University, Hamilton, Ontario, Canada
Brian C. Dow
Affiliation:
Consultant, Clinical Microbiologist; Head, Scottish National Blood Transfusion Service, National Microbiology Reference Unit, West of Scotland, Transfusion Centre, Glasgow, UK
John A. J. Barbara
Affiliation:
University of the West of England, Bristol
Fiona A. M. Regan
Affiliation:
HNSBT and Hammersmith Hospitals NHS Trust, London
Marcela Contreras
Affiliation:
University of the West of England, Bristol
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Summary

Introduction

Bacterial transmission remains a significant problem in transfusion medicine. This issue is not a new problem and was first identified more than 60 years ago with the first report of a bacterial transfusion-transmission from a blood component in 1941 (Novak, 1939; Strumia and McGraw, 1941). Since the 1970s remarkable progress has been made in increasing the safety of the blood supply with regard to viruses. Unfortunately, this has not been the case with bacterial contamination. Moreover, the continued emphasis in striving for ‘zero risk’ with regard to blood-borne viruses and in measures to prevent the ‘potential’ problem of prion transmission has possibly been to the detriment of resolving the issue of bacterial contamination. The current risk of receiving bacterially contaminated platelet concentrates, however, may be 1000 times higher than the combined risk of transfusion-transmitted infection with the human immunodeficiency virus (HIV), hepatitis C virus, hepatitis B virus and human T-cell lymphotropic virus (HTLV) (Blajchman, 2002).

In the USA, from 1985 to 1999, bacterial contamination was the most frequently reported cause of mortality after haemolytic reactions, accounting for over 10% (77/694) of transfusion fatalities (Centre for Biologics Evaluation and Research, 1999). From 1986 to 1991, 29 out of 182 (16%) transfusion-associated fatalities reported to the USA Food and Drug Administration (FDA) were caused by bacterial contamination of blood components (Hoppe, 1992).

From 1994 to 1998, the French Haemovigilance system attributed 18 deaths (four occurring in 1997) to blood components contaminated with bacteria (Debeir et al., 1999; Morel, 1999a).

Type
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Information
Transfusion Microbiology , pp. 87 - 116
Publisher: Cambridge University Press
Print publication year: 2008

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