Transfusion-transmitted bacterial infectionin the United States, 1998 through 2000

Authors

  • Matthew J. Kuehnert,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Virginia R. Roth,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • N. Rebecca Haley,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Kay R. Gregory,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Kathy V. Elder,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • George B. Schreiber,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Matthew J. Arduino,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Stacey C. Holt,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Loretta A. Carson,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Shailen N. Banerjee,

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • William R. Jarvis

    1. From the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the American Red Cross Blood Services, Arlington, Virginia; the American Association of Blood Banks, Bethesda, Maryland; the Army Blood Program Office, San Antonio, Texas; and Westat, Rockville, Maryland.
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  • Supported by Cooperative Agreements U50-CCU314273-01-1 and U50-CCU314274-01-2 with the Centers for Disease Control and Prevention, Department of Health and Human Services. The content of this article does not necessarily reflect the views or policies of the Department of Health and Human Services.

Address reprint requests to: Matthew J. Kuehnert, MD, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop A35, Atlanta, GA 30333; e-mail: mkuehnert@cdc.gov.

Abstract

BACKGROUND: Bacterial contamination of blood components can result in transfusion-transmitted infection, but the risk is not established.

STUDY DESIGN AND METHODS: Suspected cases of transfusion-transmitted bacteremia were reported to the CDC by participating blood collection facilities and transfusion services affiliated with the American Red Cross, AABB, or Department of Defense blood programs from 1998 through 2000. A case was defined as any transfusion reaction meeting clinical criteria in which the same organism species was cultured from a blood component and from recipient blood, with the organism pair confirmed as identical by molecular typing.

RESULTS: There were 34 cases and 9 deaths. The rate of transfusion-transmitted bacteremia (in events/million units) was 9.98 for single-donor platelets, 10.64 for pooled platelets, and 0.21 for RBC units; for fatal reactions, the rates were 1.94, 2.22, and 0.13, respectively. Patients at greatest risk for death received components containing gram-negative organisms (OR, 7.5; 95% CI, 1.3-64.2; p = 0.009).

CONCLUSION: Bacterial contamination of blood is an important cause of transfusion-transmitted infection; infection risk from platelet transfusion is higher compared with that from RBCs, and, overall, the risk of infection from bacterial contamination now may exceed that from viral agents. Recipients of components containing gram-negative organisms are at highest risk for transfusion-related death. The results of this study may help direct efforts to improve transfusion-related patient safety.

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