TRANSFUSION COMPLICATIONS: Bacterial culture reduces but does not eliminate the risk of septic transfusion reactions to single-donor platelets

Authors

  • Alice K. Fuller,

    1. From the Department of Pathology, Hemapheresis and Transfusion Services (HATS) Division, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
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  • Kristin M. Uglik,

    1. From the Department of Pathology, Hemapheresis and Transfusion Services (HATS) Division, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
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  • William J. Savage,

    1. From the Department of Pathology, Hemapheresis and Transfusion Services (HATS) Division, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
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  • Paul M. Ness,

    1. From the Department of Pathology, Hemapheresis and Transfusion Services (HATS) Division, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
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  • Karen E. King

    1. From the Department of Pathology, Hemapheresis and Transfusion Services (HATS) Division, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
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Alice Fuller, 550 N. Broadway, Suite 810, Baltimore, MD 21205; e-mail: fulleral@jhmi.edu.

Abstract

BACKGROUND: Transfusion-associated bacterial sepsis is a significant risk of morbidity and mortality related to platelet (PLT) transfusions. Previously the rate of septic PLT transfusion reactions (SPTRs) to single-donor PLTs (SDPs) in our hospital was determined to be 1 in 15,098 (6.6 per 100,000; 95% confidence interval [CI], 0.17-36.9 per 100,000) transfusions. The goal of this study was to determine if bacterial testing of SDPs reduced the rate of SPTRs in our hospital.

STUDY DESIGN AND METHODS: An automated microbial detection system was implemented by our blood supplier in February 2004. A retrospective examination of the number of SPTRs that have occurred to SDPs at our hospital since that time was performed, using the same criteria used before bacterial screening. Transfusions over a 3.5-year period were examined. Clinical and laboratory data were gathered and correlated from transfusion reaction files and three independent computer systems.

RESULTS: From March 1, 2004, through August 31, 2007, there were 49,625 transfusions of SDPs with 1096 transfusion reactions reported. Only one reaction detected the same organism in two of three sites, meeting our criteria for a SPTR. The rate of SPTRs in SDPs was identified as 1 in 49,625 (2.0 per 100,000; 95% CI, 0.05-11.2 per 100,000). This represents a 69.7% reduction in the incidence of SPTRs (p = 0.41).

CONCLUSION: With the implementation of bacterial testing, a decrease in the rate of SPTRs to SDPs from 6.6 per 100,000 to 2.0 per 100,000 transfusions was observed. Although not significant, these findings suggest a trend.

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