Transmissible Diseases Department, Jerome H. Holland Laboratory, American Red Cross, Rockville, Maryland 20855, USA.
Transfusion. 2009 Dec;49(12):2557-63. doi: 10.1111/j.1537-2995.2009.02317.x. Epub 2009 Jul 16.
Babesia microti, the primary cause of human babesiosis in the United States, is an intraerythrocytic parasite endemic to the Northeast and upper Midwest. Published studies indicate that B. microti increasingly poses a blood safety risk. The American Red Cross Hemovigilance Program herein describes the donor and recipient characteristics of suspected transfusion-transmitted B. microti cases reported between 2005 and 2007.
Suspected transfusion-transmitted Babesia infections were reported by transfusion services or were discovered through recipient-tracing investigations of prior donations from donors with a positive test for B. microti in a serologic study. Follow-up samples from involved donors were tested by Babesia-specific immunofluorescence assay, Western blot, and/or real-time polymerase chain reaction analysis.
Eighteen definite or probable B. microti infections, including five fatalities, were identified in transfusion recipients, 16 from hospital-reported cases and two through serologic lookback studies. Thirteen recipients were 61 to 84 years old and two were 2 years old or younger. Two recipients had sickle cell disease and four were known to be asplenic, including one with sickle cell disease. Seventeen antibody-positive donors were implicated; 11 (65%) were residents in Babesia-endemic areas, while four (24%) nonresident donors had a history of travel to endemic areas.
Transfusion-transmitted B. microti can be a significant cause of transfusion-related morbidity and mortality, especially in infant, elderly, and asplenic blood recipients. These data demonstrate the need for interventions, in both endemic and nonendemic areas of the United States, to reduce patient risk.
伯氏疏螺旋体（Babesia microti）是美国人类巴贝虫病的主要病原体，属于内红细胞寄生虫，流行于美国东北部和中西部北部。已发表的研究表明，伯氏疏螺旋体感染的血液安全风险日益增加。美国红十字会血液监测计划在此描述了 2005 年至 2007 年间报告的疑似输血传播伯氏疏螺旋体感染病例的供者和受者特征。
疑似输血传播巴贝虫感染通过输血服务机构报告，或通过对血清学研究中伯氏疏螺旋体检测阳性供者的既往献血者进行受体追踪调查发现。对涉及的供者进行后续样本检测，采用巴贝虫特异性免疫荧光分析、Western blot 和/或实时聚合酶链反应分析。
在输血受者中确定了 18 例明确或可能的伯氏疏螺旋体感染，包括 5 例死亡，其中 16 例来自医院报告的病例，2 例通过血清学回溯研究发现。13 例受者年龄为 61 至 84 岁，2 例受者年龄为 2 岁或以下。2 例受者患有镰状细胞病，4 例受者已知无脾，其中 1 例患有镰状细胞病。有 17 例抗体阳性供者被牵连；11 例（65%）居住在伯氏疏螺旋体流行地区，而 4 例（24%）非本地供者有流行地区旅行史。
输血传播的伯氏疏螺旋体可能是输血相关发病率和死亡率的重要原因，尤其是在婴儿、老年和无脾血液受者中。这些数据表明，需要在美国的流行地区和非流行地区采取干预措施，以降低患者的风险。
