Methicillin-resistant Staphylococcus aureus sepsis associated with the transfusion of contaminated platelets: a case report.
BACKGROUND
Platelet transfusion-associated sepsis is usually due to donor skin flora introduced into the unit during phlebotomy. An unusual case of a platelet component contaminated with methicillin-resistant Staphylococcus aureus (MRSA) is reported.


METHODS
A 54-year-old man, terminally ill with progressive non-Hodgkin's lymphoma, developed fever and hypotension during a platelet transfusion. He was receiving multiple antibiotics, including vancomycin. Blood cultures taken soon after transfusion were negative. An aliquot taken from the platelet pool grew MRSA at a count of 1.6 x 10(8) CFUs per mL. One of the individual bags constituting the pool showed MRSA at a count of 5.1 x 10(8) CFUs per mL. The patient died soon after the platelet transfusion. This case was reported to the FDA and submitted to the BaCon Study. The identity of the isolate and its methicillin resistance were confirmed by the CDC as part of the BaCon Study protocol. The source of contamination of the implicated unit could not be established with certainty.


CONCLUSIONS
The emergence of antimicrobial-resistant organisms poses additional challenges for the diagnosis and treatment of transfusion-associated sepsis. Measures to prevent or intercept the transfusion of contaminated platelets should be developed.
Sapatnekar
S
S
University Hospitals of Cleveland, OH 44106, USA.
Wood
E M
EM
Miller
J P
JP
Jacobs
M R
MR
Arduino
M J
MJ
McAllister
S K
SK
Kellum
M E
ME
Roth
V
V
Yomtovian
R
R
D001792:Blood Platelets / Q000382:microbiology*; D002487:Centers for Disease Control and Prevention, U.S.; D015169:Colony Count, Microbial; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000209:etiology* / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000502:physiology*; D014481:United States