How do I investigate septic transfusion reactions and blood donors with culture-positive platelet donations?

摘要

In the early 1990s, bacterial contamination of blood components was recognized as the most common cause of transfusion-transmitted infection, accounting for between 14 and 24% of transfusion associated fatalities reported to the US Food and Drug Administration and various hemovigilance systems. Because platelets (PLTs) are stored at room temperature, they provide a hospitable environment for the growth of many bacterial organisms and are most often involved in septic transfusion reactions. Many measures have been taken to prevent bacterial contamination, including verifying the donors' temperature and questioning them about infection, optimizing skin disinfection before phlebotomy, and diverting the initial aliquot of blood collected during the procedure. Blood centers have also introduced methods to detect contamination, such as culturing PLT donations and visually inspecting components before the transfusion. Indeed, since the 22nd edition in 2003, the AABB Standards for blood banks and transfusion services state mat the blood bank and transfusion service shall have methods to limit and detect bacterial contamination in all PLT components.