Davenport Patricia, Land Kevin J
Department of Medical Services, Carter BloodCare, 2205 Highway 121, Bedford, TX 76021, USA.
Transfusion. 2007 Oct;47(10):1816-9. doi: 10.1111/j.1537-2995.2007.01397.x.
Bacterial contamination of platelet (PLT) components is a leading cause of transfusion-related fatality. AABB and The College of American Pathologists require that blood centers and transfusion services have a process for detecting bacterial contamination in PLT products.
Leclercia adecarboxylata was isolated from the donated blood of a healthy, asymptomatic 61-year-old man. The PLT donation was collected by apheresis method and was separated into three daughter or split products. Samples from all three products tested positive for the presence of bacterial contamination. L. adecarboxylata was subsequently identified in two of three products. The blood donor's records were reviewed and the donor was interviewed by telephone. The only possible risk identified during the interview was a questionable contact dermatitis, away from the antecubital fossa, thought to be due to poison ivy exposure before the donation. All subsequent donations have tested negative for the presence of bacterial contamination. The organism is a Gram-negative bacillus variant of the Enterobacteriaceae family and known nosocomial isolate. It has been previously reported as a rarely isolated opportunistic pathogen mostly associated with patients having compromised immunity, chronic or inflammatory illness, catheter-related bacteremia, or mixed-bacterial wounds. L. adecarboxylata was originally identified in water, foods, and environment.
This is the first known report of isolation of L. adecarboxylata from the blood donation of an apparently healthy individual and could represent transient asymptomatic bacteremia or more likely contamination by epidermal flora. The organism may be underrecognized due to its close resemblance to Escherichia coli.
血小板（PLT）成分的细菌污染是输血相关死亡的主要原因。美国血库协会（AABB）和美国病理学家学会要求血液中心和输血服务机构具备检测PLT产品中细菌污染的流程。
从一名61岁健康无症状男性的献血中分离出非脱羧勒克菌。该PLT捐献采用单采法采集，并被分成三个子产品或分装产品。所有三个产品的样本检测出细菌污染呈阳性。随后在三个产品中的两个中鉴定出非脱羧勒克菌。审查了献血者的记录，并通过电话对献血者进行了访谈。访谈中确定的唯一可能风险是疑似接触性皮炎，位于肘前窝以外，据认为是由于献血前接触了毒葛。所有后续捐献的细菌污染检测均为阴性。该菌是肠杆菌科的革兰氏阴性杆菌变种，是已知的医院分离株。此前曾报道其为一种罕见分离的机会致病菌，主要与免疫力低下、患有慢性或炎症性疾病、导管相关菌血症或混合细菌伤口的患者有关。非脱羧勒克菌最初在水、食物和环境中被鉴定出来。
这是首次从一名看似健康个体的献血中分离出非脱羧勒克菌的已知报告，可能代表短暂无症状菌血症，或更可能是表皮菌群污染。由于该菌与大肠杆菌非常相似，可能未被充分认识。
