Transfusion-transmitted bacterial infection in the United States, 1998 through 2000.
BACKGROUND
Bacterial contamination of blood components can result in transfusion-transmitted infection, but the risk is not established.


METHODS
Suspected cases of transfusion-transmitted bacteremia were reported to the CDC by participating blood collection facilities and transfusion services affiliated with the American Red Cross, AABB, or Department of Defense blood programs from 1998 through 2000. A case was defined as any transfusion reaction meeting clinical criteria in which the same organism species was cultured from a blood component and from recipient blood, with the organism pair confirmed as identical by molecular typing.


RESULTS
There were 34 cases and 9 deaths. The rate of transfusion-transmitted bacteremia (in events/million units) was 9.98 for single-donor platelets, 10.64 for pooled platelets, and 0.21 for RBC units; for fatal reactions, the rates were 1.94, 2.22, and 0.13, respectively. Patients at greatest risk for death received components containing gram-negative organisms (OR, 7.5; 95% CI, 1.3-64.2; p = 0.009).


CONCLUSIONS
Bacterial contamination of blood is an important cause of transfusion-transmitted infection; infection risk from platelet transfusion is higher compared with that from RBCs, and, overall, the risk of infection from bacterial contamination now may exceed that from viral agents. Recipients of components containing gram-negative organisms are at highest risk for transfusion-related death. The results of this study may help direct efforts to improve transfusion-related patient safety.
Kuehnert
M J
MJ
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. mkuehnert@cdc.gov
Roth
V R
VR
Haley
N R
NR
Gregory
K R
KR
Elder
K V
KV
Schreiber
G B
GB
Arduino
M J
MJ
Holt
S C
SC
Carson
L A
LA
Banerjee
S N
SN
Jarvis
W R
WR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000401:mortality / Q000635:transmission*; D001771:Blood Banks; D001800:Blood Specimen Collection; D001803:Blood Transfusion / Q000706:statistics & numerical data; D018563:Disease Notification; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000706:statistics & numerical data; D016905:Gram-Negative Bacterial Infections / Q000401:mortality / Q000635:transmission; D006801:Humans; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects / Q000706:statistics & numerical data; D012307:Risk Factors; D012308:Risk Management; D065227:Transfusion Reaction