Decreased sepsis related to indwelling venous access devices coincident with implementation of universal leukoreduction of blood transfusions.
BACKGROUND
Randomized trials and animal models demonstrate that leukoreduction of transfusions can reduce the risk of post-operative infections. We performed a retrospective study of sepsis related to indwelling venous access devices (line related infections) before and after the July 2000 implementation of universal leukoreduction.


METHODS
Line related infection data were collected from hospital infection control records for an 18-month period before and after July 2000. Transfusion histories were obtained from transfusion service records.


RESULTS
Line related infections decreased in number from 150 to 98 (-35%) in transfused patients after implementation of universal leukoreduction, whereas line related infections increased from 41 to 45 (+10%) in nontransfused patients (p = 0.04). This corresponded to a decrease from 5.3 to 3.3 infections/10,000 patient days in transfused patients (p = 0.002). The infection rate remained stable in nontransfused patients at 1.5 infections/10,000 patient days both pre- and postimplementation of universal leukoreduction. Quantitatively similar decreases (33-45%) were seen in transfused surgical, medical and pediatric patients.


CONCLUSIONS
A substantial and statistically significant decrease in line related infections occurred coincident with implementation of universal leukoreduction. These improved outcomes were observed in transfused but not nontransfused patients, across all clinical services, suggesting a causal relationship with universal leukoreduction.
Blumberg
Neil
N
Transfusion Medicine Unit, Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA. neil_blumberg@urmc.rochester.edu
Fine
Lynn
L
Gettings
Kelly F
KF
Heal
Joanna M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007902:Length of Stay / Q000706:statistics & numerical data; D047589:Leukocyte Reduction Procedures; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D017713:Platelet Transfusion; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology