• Open Access

TRANSFUSION COMPLICATIONS: Bacterial contamination of pediatric whole blood transfusions in a Kenyan hospital

Authors

  • Oliver Hassall,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Kathryn Maitland,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Lewa Pole,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Salim Mwarumba,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Douglas Denje,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Kongo Wambua,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Brett Lowe,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Christopher Parry,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Kishor Mandaliya,

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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  • Imelda Bates

    1. From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Liverpool School of Tropical Medicine and the Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, Liverpool, UK; the Department of Paediatrics, Imperial College London, London, UK; and the Coast Provincial General Hospital and Regional Blood Transfusion Centre, Mombasa, Kenya.
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Dr Oliver Hassall, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi 80108, Kenya; e-mail: ohassall@gmail.com.

Abstract

BACKGROUND: Hospitalized children in sub-Saharan Africa frequently receive whole blood transfusions for severe anemia. The risk from bacterial contamination of blood for transfusion in sub-Saharan Africa is not known. This study assessed the frequency of bacterial contamination of pediatric whole blood transfusions at a referral hospital in Kenya.

STUDY DESIGN AND METHODS: This was an observational study. Over the course of 1 year, bacteriologic cultures were performed on 434 of the 799 blood packs issued to children by the blood bank of Coast Provincial General Hospital, Mombasa. Clinical outcome was not assessed.

RESULTS: Forty-four bacterial contaminants were isolated from 38 blood packs—an overall contamination frequency of 8.8% (95% confidence interval, 6.1%-11.4%). Sixty-four percent of the bacteria isolated were Gram-negative. Many of the isolates are usually found in the environment and the most likely source of contamination was considered to be the hospital blood bank.

CONCLUSION: Bacterial contamination of whole blood may be a significant but unrecognized hazard of blood transfusion for children in sub-Saharan Africa. Further work is needed to clarify the extent of the problem and its clinical consequences. Increased awareness and adherence to basic principles of asepsis in the hospital blood bank may be important immediate interventions.

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