CDC investigates 4 patients with sepsis following contaminated platelet transfusions



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The source of bacterial contamination of platelets is not clear. An analysis by the Centers for Disease Control and Prevention found that the bacteria were closely related and that the contamination could come from a common source. An investigation is underway.

Sepsis, a medical emergency, occurs when an existing infection triggers an extreme reaction and a chain reaction throughout the body, possibly resulting in tissue damage, organ failure and death.

Platelets, small cell structures essential for blood clotting, can be collected from donors and transferred to a patient by intravenous transfusion. According to the American Red Cross, donor blood is collected during the collection of platelets for transfusion. It is then removed from an apheresis cell separation machine, which extracts the platelets and returns the rest of the blood to the donor.
In the United States, about 1 in 5,000 platelets are contaminated with bacteria, according to the US Food and Drug Administration.

"Our blood supply is very safe"

Contaminants found in platelet transfusions at the origin of sepsis were the complex Acinetobacter calcoaceticus-baumannii (ACBC) and Staphylococcus saprophyticus, two typical causes of healthcare-associated infections, reported the CDC. Taking samples from each patient, the CDC analyzed the bacterial DNA and discovered close relationships, suggesting a common source of contamination.

All collection sets used with apheresis machines came from the same manufacturer, while two of the three sets were associated with the same batch, reported the CDC without revealing the name of the manufacturer. The survey did not identify the source of contamination.

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Dr. Amesh Adalja, spokesperson for the American Society of Infectious Diseases and senior scientist at the Johns Hopkins Center for Safety, said that "in general, our blood supply is very safe" and that the fact that this deserved a major investigation of the CDC "highlights the fact that it is a rather rare event."

Adalja, who has not participated in the CDC's investigation, explained that "blood products are a good way to fight infectious diseases" because they are added to the patient's bloodstream. And platelets are the blood product most likely to cause an infection; they are stored at room temperature, which allows the proliferation of any potential contaminating pathogen.

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"There will always be a risk of infection by blood products," said Adalja. Nevertheless, patients admitted to a hospital should be aware that the risk is "as low as it has been in the past, modern technologies and modern screening procedures have largely contributed to reducing these risks", he said. -he declares. "Once the investigation is completed, corrective measures will be put in place."

Four cases of sepsis

The Californian patient, a man with acute lymphoblastic leukemia, began to shake a few minutes after the end of the platelet transfusion. Two hours later, he had a fever and his blood pressure was low. He completely recovered after being transferred to the intensive care unit for septic shock management. A culture of what has remained in the wafer bag has grown both ACBC and Staph. The contamination was attributed to a single donation collected five days earlier in California.

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The patient from Utah, a man with cirrhosis who needed a platelet transfusion before an operation, complained of chills an hour after the start of his transfusion. Two hours later, he was feverish, his blood pressure was low and his breathing was fast. Two days later, he died of septic shock. Samples obtained from platelet shakers at the manufacturing facility and at the hospital yielded ACBC isolates. The platelets had been collected in Utah.

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Connecticut patients, two men with acute myeloid leukemia, each received a unit of platelets manufactured from the same apheresis donation, collected in Massachusetts. Less than two hours after the transfusion, both patients became feverish and their blood pressure dropped. Both recovered after being transferred to intensive care. ACBC and Staph were isolated from the remaining platelets in both bags.

Healthcare providers must monitor patients for sepsis during platelet transfusion, the CDC advised. Recognizing an unusual reaction of the patient and informing the platelet provider and administrators of the blood supply system is essential to prevent sepsis associated with contaminated platelets.

Over the past decade, CBAA organisms, which can cause ventilator-induced pneumonia and urinary tract infections, surgical wounds and blood, have shown increased resistance to antimicrobials, with some strains now resistant to all commonly used antibiotics.
Staphylococcus saprophyticus bacteria do not usually cause infections outside health care facilities, but in hospitals and other settings, infections can become serious or even fatal.

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