Relationship between Bacterial Load, Species Virulence, and Transfusion Reaction with Transfusion of Bacterially Contaminated Platelets

Jacobs, Michael; Good, Caryn E.; Lazarus, Hillard M.; Yomtovían, Roslyn

doi:10.1086/529143

Cited by 158 publications

(210 citation statements)

References 20 publications

Supporting

Mentioning

197

Contrasting

Unclassified

Order By: Relevance

“…The not yet optimized detection limit of 10 4 live bacteria is close to what is shown to be relevant by Jacobs et al, (2008): "A detection method with a 10 3 colonyforming units/ml threshold would detect 90% of contaminants." Notably, up to 10 9 CFU have been found in expired platelet concentrates.…”

Section: Iccvam Recommendations For Future Mat Validation Studies Maymentioning

confidence: 70%

“…Recently, attention has focused on viral infections, although the incidence of HIV in blood products is less than 1 in 1,000,000 per unit (1 in 3,000 for bacterial contaminations) (Blajchman et al, 2005). Endotoxin determinations have been performed in some studies (Jacobs et al, 2008;Palavecino et al, 2010), but they are limited to Gram-negative infestations, which represent the minority of cases (e.g., out of 52 contaminated platelet concentrates reported by Jacobs et al, 2008, four were of Gram-negative origin), and do not allow determining cellbound pyrogens. Two large studies in France (BACTHEM study, Perez et al, 2001) and the USA (BaCon study, Kuehnert et al, 2001) revealed that platelets hold a significantly higher risk of bacterial contamination than erythrocyte concentrates, irrespective of their being single-donor or pooled preparations.…”

Section: Iccvam Recommendations For Future Mat Validation Studies Maymentioning

confidence: 99%

See 1 more Smart Citation

The human whole blood pyrogen test – lessons learned in twenty years

Hartung

2015

ALTEX

View full text Add to dashboard Cite

Section: Iccvam Recommendations For Future Mat Validation Studies Maymentioning

confidence: 70%

Section: Iccvam Recommendations For Future Mat Validation Studies Maymentioning

confidence: 99%

The human whole blood pyrogen test – lessons learned in twenty years

Hartung

2015

ALTEX

View full text Add to dashboard Cite

“…7 Active surveillance was performed by collecting 1-to 2-mL aliquots of apheresis or pooled platelet units at the time of issue for culture (see "Microbiology methods" below). Patients were evaluated for evidence of transfusion reactions as soon as positive culture results were obtained.…”

Section: Surveillance For Bacterial Contamination Of Platelet Units Amentioning

confidence: 99%

“…Investigation of transfusion reactions to platelets includes patient evaluation and Gram stain and culture of the remains of implicated platelet units. Patients' transfusion reactions, documented by active or passive surveillance, were classified by severity as previously described 7 and correlated with platelet and posttransfusion blood cultures and other investigations.…”

Section: Surveillance For Bacterial Contamination Of Platelet Units Amentioning

confidence: 99%

“…5,6 Further confounding our understanding of this problem is the recognition of septic transfusion reactions (STRs) resulting from transfusion of bacterially contaminated platelets. 7 Criteria for the diagnosis of STRs caused by bacterial contamination of platelets have been established to trigger recognition, management, and further investigation. 8 These criteria, however, broadly overlap with the diagnostic criteria for other noninfectious transfusion reactions such as febrile-like/febrile nonhemolytic transfusion reactions (FNHTRs) and hypotensive transfusion reactions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Detection of septic transfusion reactions to platelet transfusions by active and passive surveillance

Hong

Xiao

Lazarus

et al. 2016

Blood

173

230

View full text Add to dashboard Cite

• Bacterial sepsis from contaminated platelet transfusions continues to occur despite recent interventions; additional measures are needed.• STR to platelet transfusion is frequently not recognized or reported; use of recent AABB criteria showed highest diagnostic sensitivity.Septic transfusion reactions (STRs) resulting from transfusion of bacterially contaminated platelets are a major hazard of platelet transfusion despite recent interventions. Active and passive surveillance for bacterially contaminated platelets was performed over 7 years (2007)(2008)(2009)(2010)(2011)(2012)(2013) by culture of platelet aliquots at time of transfusion and review of reported transfusion reactions. All platelet units had been cultured 24 hours after collection and released as negative. Five sets of STR criteria were evaluated, including recent AABB criteria; sensitivity and specificity of these criteria, as well as detection by active and passive surveillance, were determined. Twenty of 51 440 platelet units transfused (0.004%; 389 per million) were bacterially contaminated by active surveillance and resulted in 5 STRs occurring 9 to 24 hours posttransfusion; none of these STRs had been reported by passive surveillance. STR occurred only in neutropenic patients transfused with high bacterial loads. A total of 284 transfusion reactions (0.55%) were reported by passive surveillance. None of these patients had received contaminated platelets. However, 6 to 93 (2.1%-32.7%) of these 284 reactions met 1 or more STR criteria, and sensitivity of STR criteria varied from 5.1% to 45.5%. These results document the continued occurrence of bacterial contamination of platelets resulting in STR in neutropenic patients, failure of passive surveillance to detect STR, and lack of specificity of STR criteria. These findings highlight the limitations of reported national STR data based on passive surveillance and the need to implement further measures to address this problem such as secondary testing or use of pathogen reduction technologies. (Blood. 2016;127(4):496-502)

show abstract

Pathogen-reduced platelets for the prevention of bleeding

Estcourt

Malouf

Hopewell

et al. 2017

Cochrane Database of Systematic Reviews

117

View full text Add to dashboard Cite

Background Platelet transfusions are used to prevent and treat bleeding in people who are thrombocytopenic. Despite improvements in donor screening and laboratory testing, a small risk of viral, bacterial, or protozoal contamination of platelets remains. There is also an ongoing risk from newly emerging blood transfusion-transmitted infections for which laboratory tests may not be available at the time of initial outbreak. One solution to reduce the risk of blood transfusion-transmitted infections from platelet transfusion is photochemical pathogen reduction, in which pathogens are either inactivated or significantly depleted in number, thereby reducing the chance of transmission. This process might offer additional benefits, including platelet shelf-life extension, and negate the requirement for gamma-irradiation of platelets. Although current pathogen-reduction technologies have been proven to reduce pathogen load in platelet concentrates, a number of published clinical studies have raised concerns about the effectiveness of pathogen-reduced platelets for post-transfusion platelet count recovery and the prevention of bleeding when compared with standard platelets. This is an update of a Cochrane review first published in 2013. Objectives To assess the effectiveness of pathogen-reduced platelets for the prevention of bleeding in people of any age requiring platelet transfusions. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1950), and ongoing trial databases to 24 October 2016. Selection criteria We included RCTs comparing the transfusion of pathogen-reduced platelets with standard platelets, or comparing different types of pathogen-reduced platelets. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We identified five new trials in this update of the review. A total of 15 trials were eligible for inclusion in this review, 12 completed trials (2075 participants) and three ongoing trials. Ten of the 12 completed trials were included in the original review. We did not identify any RCTs comparing the transfusion of one type of pathogen-reduced platelets with another. Nine trials compared Intercept® pathogen-reduced platelets to standard platelets, two trials compared Mirasol® pathogen-reduced platelets to standard platelets; and one trial compared both pathogen-reduced platelets types to standard platelets. Three RCTs were randomised cross-over trials, and nine were parallel-group trials. Of the 2075 participants enrolled in the trials, 1981 participants received at least one platelet transfusion (1662 participants in Intercept® platelet trials and 319 in Mirasol® platelet trials). One trial included children requiring cardiac surgery (16 participants) or adults requiring a liver transplant (28 participants). All of the other...

show abstract

Relationship between Bacterial Load, Species Virulence, and Transfusion Reaction with Transfusion of Bacterially Contaminated Platelets

Cited by 158 publications

References 20 publications

The human whole blood pyrogen test – lessons learned in twenty years

The human whole blood pyrogen test – lessons learned in twenty years

Detection of septic transfusion reactions to platelet transfusions by active and passive surveillance

Pathogen-reduced platelets for the prevention of bleeding

Contact Info

Product

Resources

About