Platelet Contamination

Although I knew it was possible to have bacterial contamination in blood products, I did not realize the prevalence of the problem until this week in lab. We received a unit of platelets after a patient suffered a septic transfusion reaction. After culturing, our unit grew Candida albicans, which is a yeast species. This experience inspired me to look into blood product contamination further.

Bacterial contamination should be included in any investigation of a febrile transfusion reaction. Platelets post the highest risk of contamination since they are stored at room temperature. This leads to their shortened expiration time of 5 days from collection. The CDC claims that 1 in 1,000-3,000 units are may be contaminated. Bacterial contamination is the second leading cause of transfusion associated deaths.

The main organisms of public health significance are:

Bacillus anthracis

Yersinia pestis

Francisella tularensis

Clostridium botulinum

Listeria monocytogenes

Salmonella spp

Shigella spp

Group A Streptococcus

Streptococcus pneumoniae

Neisseria meningitides

Neisseria gonnorrheae

If a septic transfusion is suspected, the transfusion should be ceased immediately. Urine and blood samples should be collected and sent to us (the lab). After susceptibilities are determined for the culprit agent, symptomatic patients should receive the medication that the organism is susceptible.

There are simple ways to prevent this from happening. The main one is to cleanse the donor site thoroughly with alcohol followed by an iodine based disinfectant for a full 2 minutes. The next time you are donating, time the phlebotomist!