Bacterial contamination of blood components

Abstract

Blood for transfusion is a potential source of infection by a variety of known and unknown transmissible agents. Over the last 20 years, astounding reductions in the risk of viral infection via allogeneic blood have been achieved. As a result of this success, bacterial contamination of blood products has emerged as the greatest residual source of transfusion-transmitted disease. This paper summarizes the current status of detection, prevention, and elimination of bacteria in blood products for transfusion.

FIG. 1.

Risk of infectious disease transmission per unit transfused by year, 1983 to 2001. Reprinted from reference with permission of the publisher.

FIG. 2.

Growth curves of four units of AS-3 red blood cells inoculated with S. liqueifaciens (two units inoculated to 4.2 CFU/ml) and Y. enterocolitica (two units inoculated to 11.6 CFU/ml) (5a). Bacteria were not detectable by culture until days 3 to 6. Isolates were from strains actually implicated in post-red-blood-cell-transfusion sepsis (the isolates were kindly provided by M. Arduino, Centers for Disease Control and Prevention, Atlanta, Ga.).

FIG. 3.

Growth curves of six bacteria species (S. marcescens, n = 7; K. pneumoniae, n = 21; S. epidermidis, n = 21; Pseudomonas sp., n = 15; B. cereus, n = 9; S. aureus, n = 22) in 95 platelet units. All bacteria were inoculated on day zero at 10-50 CFU/ml (10).