Transfusion infections

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Background

  • Absolute risk of nosocomial infection in conservatively vs liberally transfused patients: 12% vs 17%[1]
  • Bacterial contamination of products, especially platelets
    • 1 of 2000-3000 platelet transfusions results in bacterial infection[2]
    • Gram-positive bacteria (e.g. staph due to contamination with skin puncture during collection
    • Gram-negative bacteria (e.g. e. coli) due to asymptomatic bacteremia in donor
    • Anaplasmosis, brucellosis, ehrlichiosis have all been documented[3][4][5]
  • Parasitic infection: rare but reported. Those reporting recent travel to malaria-endemic regions are barred from donation
  • Viral infections
    • Risk of infection from single transfusion[6] in the US:
    • HIV infection: 1 in 2 million
    • HBV: 1 in 300,000
    • HCV: 1 in 1.5 million
    • West nile virus: 1 in 350,000
  • Prion disease

Clinical Features

Differential Diagnosis

Evaluation

Management

Disposition

See Also

External Links

References

  1. Rohde JM, Dimcheff DE, Blumberg N, et al. Health care-associated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA. 2014;311(13):1317-26.
  2. Fuller, A. K., Uglik, K. M., Savage, W. J., Ness, P. M., & King, K. E. (2009). Bacterial culture reduces but does not eliminate the risk of septic transfusion reactions to single-donor platelets. Transfusion, 49(12), 2588-93.
  3. Jereb M, Pecaver B, Tomazic J, et al. Severe human granulocytic anaplasmosis transmitted by blood transfusion. Emerg Infect Dis. 2012;18(8):1354-7.
  4. Economidou J, Kalafatas P, Vatopoulou T, Petropoulou D, Kattamis C. Brucellosis in two thalassaemic patients infected by blood transfusions from the same donor. Acta Haematol. 1976;55:244–249
  5. Regan J, Matthias J, Green-Murphy A, Stanek D, Bertholf M, Pritt BS, Sloan LM, Kelly AJ, Singleton J, McQuiston JH, Hocevar SN, Whittle J. A Confirmed Ehrlichia ewingii Infection Likely Acquired Through Platelet Transfusion, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages e105–107
  6. https://www.redcrossblood.org/donate-blood/blood-donation-process/what-happens-to-donated-blood/blood-transfusions/risks-complications.html