Early recognition and reporting of suspected bacterial contamination may prevent transfusion transmission of infection by associated units.

摘要

Currently, the greatest risk of transfusion transmitted infection (TTI) is. associated with the bacterial contamination of platelets (Blajchman et al., 2005). In 2009, a retrospective investigation was initiated after an expired unit of paediatric platelets was found to have a low pH (5.59 at 21.5 degC) and abnormal colouration on routine quality monitoring. Investigation of the unit by the National Bacteriology Laboratory (NBL) at the National Health Service Blood and Transplant revealed significant growth of Streptococcus pneumoniae, and so the fate of all associated packs was investigated. The apheresis donation had been split into one adult (approximate volume: 200 mL) and four paediatric (approximate volume: 40 mL) packs on day 1 (day 0 being the day of donation). Four of these units had been transfused into two recipients with acute myeloid leukaemia (AML), one to an adult patient and three paediatric packs to an infant. No adverse reactions were reported in the blood service at the time of the transfusions; however, a look-back investigation revealed that both recipients had displayed signs at or around the time of transfusion that were indicative of a possible acute transfusion reaction.