A prospective study of symptomatic bacteremia following platelet transfusion and of its management

Chiu, Ekw; Yuen, KY; Lie, Albert K. W.; Liu, Ruiming; Lau, Yu Lung; Lee, A. C. W.; Kwong, Yok–Lam; Wong, S.P.; Ng, Margaret H.L.; Chan, T. K.

doi:10.1046/j.1537-2995.1994.341195065031.x

Cited by 131 publications

(67 citation statements)

References 30 publications

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“…Ironically, the majority (85%) of platelets are transfused to patients in the medical oncology, hematology, pediatric hematology/oncology, and bone marrow transplantation settings, all typically immunosuppressed patients (61). A study of platelet transfusions in autologous bone marrow transplant patients found that 1 in 2,000 units of platelet concentrates associated with a febrile episode (within 24 h of transfusion) were linked to bacterially contaminated platelets (16). Of the 10 patients known to have received a bacterially contaminated unit, 4 experienced septic shock.…”

Section: Clinical Presentationmentioning

confidence: 99%

Bacterial Contamination of Blood Components

2005

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Blood for transfusion is a potential source of infection by a variety of known and unknown transmissible agents. Over the last 20 years, astounding reductions in the risk of viral infection via allogeneic blood have been achieved. As a result of this success, bacterial contamination of blood products has emerged as the greatest residual source of transfusion-transmitted disease. This paper summarizes the current status of detection, prevention, and elimination of bacteria in blood products for transfusion

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Section: Clinical Presentationmentioning

confidence: 99%

Bacterial Contamination of Blood Components

2005

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“…Episodes of bacteraemia as a result of platelet transfusion were excluded from the study. 6 All isolates in polymicrobial bacteraemia, multiple episodes of bacteraemia and break-through bacterae-mia were included, but any patient with multiple isolates was counted only once in the statistical analysis for risk factors predisposing to bacteraemia.…”

Section: Patients and Antimicrobial Prophylaxismentioning

confidence: 99%

Unique risk factors for bacteraemia in allogeneic bone marrow transplant recipients before and after engraftment

Yuen

Woo

Hui

et al. 1998

Bone Marrow Transplant

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Summary:A study of the risk factors associated with bacteraemia in 191 allogeneic bone marrow transplant (BMT) recipients (1991-1996) was performed. In contrast to risk factors commonly cited for cancer chemotherapy, mucositis, degree of conditioning toxicity of the gut and lungs, duration of neutropenia, and severity of neutropenia and monocytopenia were not associated with bacteraemia in the pre-engraftment period, during which the only significant risk factor was late stage underlying disease (P Ͻ 0.05). After engraftment, Hickman catheter infection, and severe acute and chronic graft-versushost disease (GVHD) were found to be independently associated with bacteraemia by multivariate analysis (P Ͻ 0.001, Ͻ0.05 and Ͻ0.05, respectively). This might be explained by intense antimicrobial prophylaxis, early empirical treatment, and non-routine use of haemopoietic growth factors. No significant difference in mortality was detected between bacteraemic and non-bacteraemic patients in both periods. Allogeneic BMT recipients are therefore a group of patients distinct from other cancer patients receiving chemotherapy at risk of developing bacteraemia. The study findings prompt consideration of a management protocol incorporating early and routine use of haemopoietic growth factors before engraftment in high-risk patients with late stage underlying malignancies, routine antimicrobial prophylaxis for acute GVHD with intense immunosuppression, and intravenous immunoglobulin therapy for chronic GVHD. Further cost-benefit analyses are warranted.

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“…Although temporarily effective in controlling severe thrombocytopenia, platelet transfusion therapy is associated with several problems, including refractoriness and alloimmunization, transmission of infectious agents, and transfusion reactions. [9][10][11][12][13][14][15] The limited supply of blood products can also be problematic. The use of doseintensive chemotherapy regimens and hematopoietic progenitor cell transplantation, as well as intensive support for the medical and surgical patient, has resulted in an increasing demand for platelet products; this demand is likely to escalate in an attempt to improve clinical outcomes for oncology and nononcology patients.…”

Section: Introductionmentioning

confidence: 99%

Recombinant human thrombopoietin: basic biology and evaluation of clinical studies

Kuter

Begley

2002

Blood

338

236

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Thrombocytopenia is a common medical problem for which the main treatment is platelet transfusion. Given the increasing use of platelets and the declining donor population, identification of a safe and effective platelet growth factor could improve the management of thrombocytopenia. Thrombopoietin (TPO), the c-Mpl ligand, is the primary physiologic regulator of megakaryocyte and platelet development.

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A prospective study of symptomatic bacteremia following platelet transfusion and of its management

Abstract: Significant febrile reactions after platelet transfusion are highly likely to be indicative of bacteremia. Routine retention of platelet bags for subsequent microbiologic study was useful in the investigation of these febrile reactions. Empiric antibiotic therapy is indicated.

Cited by 131 publications

References 30 publications

Bacterial Contamination of Blood Components

Bacterial Contamination of Blood Components

Unique risk factors for bacteraemia in allogeneic bone marrow transplant recipients before and after engraftment

Recombinant human thrombopoietin: basic biology and evaluation of clinical studies

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