Yersinia enterocolitica bacteremia and endotoxin shock associated with red blood cell transfusions - United States, 1991

Article Abstract:

An investigation was carried out by the Centers for Disease Control (CDC) into reports of cases of Yersinia enterocolitica bacteremia (presence in the blood of the Yersinia enterocolitica organism, which causes diarrheal disease) that were associated with blood transfusions. In six cases, patients who were receiving transfusions of red blood cells (RBCs) developed fevers and decreased blood pressure within 50 minutes after the transfusion began. Explosive diarrhea developed in one patient within 10 minutes. Four of these patients died as a result of the blood contamination. Studies identified Yersinia enterocolitica in cultures from the blood remaining in the blood bag. Questioning of the donors revealed that three had experienced diarrhea within 30 days of donation, one had diarrhea on the day of donation, and two had had no diarrheal illness. The total number of patients with severe transfusion-associated reactions was 10, of whom seven died. It is possible that the incidence of gastrointestinal disease due to this organism is increasing. The donors of infected blood probably had very low levels of bacteremia when they donated. Measures to prevent RBC contamination by Yersinia enterocolitica in donated blood include screening donors for their histories of gastrointestinal disease; reducing the shelf-life of RBCs (since the organism can proliferate after 10 to 20 days when stored); and testing RBCs that have been stored 25 days or longer for organisms or endotoxins (toxins within bacteria with potent physiologic effects). These approaches are briefly evaluated. Transfusion-associated Yersinia enterocolitica infections and fatalities must be reported by physicians to the CDC. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Bacteremia, Blood donors, Blood donation

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Septic reactions to platelet transfusions: a persistent problem

Article Abstract:

Platelets, which are important in clotting, are the only blood product that can be stored at room temperature. They are susceptible to bacterial infection, which can cause severe illness and death if the contaminated platelets are used for transfusions. The incidence of such contaminated transfusions increased soon after the Food and Drug Administration extended the allowable storage time to seven days, causing the agency to return its policy soon afterwards to the previous maximum storage time of five days. Septic transfusion reactions have decreased since then, but still occur at a fairly high rate. This study examined such reactions in one institution to see how their incidence might be further reduced. All patients receiving transfusions at a cancer center were monitored over a 42-month period. All septic reactions to platelet transfusion were identified and analyzed. Out of 4,200 transfusions during the study period, there were seven septic reactions to platelet transfusions. All seven patients were taking antibiotics effective against the bacteria. Fever occurred soon after the transfusions were given. Four of the seven platelet transfusions were from sources that had been stored five days. The incidence of septic reactions was five times higher for platelets stored five days than for those stored four or fewer days. Examination of the donors of the platelets revealed they were not infected, suggesting that contamination occurred during the puncturing of the skin with the needle or elsewhere in the donation process. These results indicate that septic reactions to platelet transfusion could further be reduced by reducing the allowable storage time to four days. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Septic shock, Blood platelets, Platelet transfusion

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Red blood cell transfusions contaminated with Yersinia enterocolitica - United States, 1991-1996, and initiation of a national study to detect bacteria-associated transfusion reactions

Article Abstract:

Ten patients receiving a blood transfusion between 1991 and 1996 became ill with Yersinia enterocolitica infection. These can be added to the 11 cases reported between 1985 and 1991. Eight of the ten patients became ill within 12 hours of the transfusion. Five died between 2.5 hours and 6 days after the transfusion. Blood samples from five of the patients contained Yersinia toxins and the bacterium itself was isolated from the blood of seven patients. Blood samples from seven of the donors also tested positive for Yersinia enterocolitica. Five of the donors reported having diarrhea after the donation.

Causes of, Bacterial infections

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