title: Bacterial contamination of pediatric whole blood transfusions in a Kenyan hospital.
abstract: BACKGROUND
  Hospitalized children in sub-Saharan Africa frequently receive whole blood transfusions for severe anemia. The risk from bacterial contamination of blood for transfusion in sub-Saharan Africa is not known. This study assessed the frequency of bacterial contamination of pediatric whole blood transfusions at a referral hospital in Kenya.
  
  
  METHODS
  This was an observational study. Over the course of 1 year, bacteriologic cultures were performed on 434 of the 799 blood packs issued to children by the blood bank of Coast Provincial General Hospital, Mombasa. Clinical outcome was not assessed.
  
  
  RESULTS
  Forty-four bacterial contaminants were isolated from 38 blood packs-an overall contamination frequency of 8.8% (95% confidence interval, 6.1%-11.4%). Sixty-four percent of the bacteria isolated were Gram-negative. Many of the isolates are usually found in the environment and the most likely source of contamination was considered to be the hospital blood bank.
  
  
  CONCLUSIONS
  Bacterial contamination of whole blood may be a significant but unrecognized hazard of blood transfusion for children in sub-Saharan Africa. Further work is needed to clarify the extent of the problem and its clinical consequences. Increased awareness and adherence to basic principles of asepsis in the hospital blood bank may be important immediate interventions.
authors.affiliation: Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya.
authors.forename: Oliver
authors.initials: O
authors.lastname: Hassall
authors.forename: Kathryn
authors.initials: K
authors.lastname: Maitland
authors.forename: Lewa
authors.initials: L
authors.lastname: Pole
authors.forename: Salim
authors.initials: S
authors.lastname: Mwarumba
authors.forename: Douglas
authors.initials: D
authors.lastname: Denje
authors.forename: Kongo
authors.initials: K
authors.lastname: Wambua
authors.forename: Brett
authors.initials: B
authors.lastname: Lowe
authors.forename: Christopher
authors.initials: C
authors.lastname: Parry
authors.forename: Kishor
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Imelda
authors.initials: I
authors.lastname: Bates
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology* / Q000635:transmission*; D001771:Blood Banks / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000635:transmission; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000635:transmission; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control; D007630:Kenya / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D065227:Transfusion Reaction
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