Fang Deanna C, McCullough Jeffrey
Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL.
Department of Laboratory Medicine and Pathology-MMC 609, University of Minnesota, Minneapolis, MN.
Transfus Med Rev. 2016 Jul;30(3):132-8. doi: 10.1016/j.tmrv.2016.04.002. Epub 2016 Apr 28.
Because testing of donors for Babesia microti has become available, it is important to determine the kinds of patients who should receive B microti-tested blood. We searched PubMed, AABB abstracts, and FDA Web site to identify all cases of transfusion-transmitted babesiosis (TTB). Cases were analyzed for underlying medical condition, age, presence of spleen, and reason for transfusion in relation to 5 classes of recipient outcome severity. Sixty-seven reports included 256 transfusion cases where donor tested positive for B microti, 165 of which resulted in TTB. Sixty recipients did not develop disease or become test positive, and test results were not known for 31 more. The 165 cases of TTB involved hematologic (19%), neonate (10%), cardiovascular (8%), and gastrointestinal (6%) patients. Thirty-two (19%) of the 165 infected patients died with death attributed to babesiosis in 25 of the cases. Nine (5%) were asymptomatic, 27 (16%) were symptomatic but had uncomplicated disease, and 16 (10%) had complicated disease. The severity of disease was mixed among many disease categories. Patients >65 years of age included the largest number of recipients (59/165, 36%) and deaths (11/32, 34%), although deaths occurred in other age groups as well. TTB cases were predominantly due to red cells (133 of 140 specified units), with red blood cell units processed in a variety of ways and at all storage duration. TTB with complicated babesiosis and/or death occurred in patients of all age groups and with a variety of underlying medical conditions.
由于现已能够对献血者进行微小巴贝斯虫检测，因此确定哪些患者应接受经微小巴贝斯虫检测的血液至关重要。我们检索了PubMed、美国血库协会（AABB）摘要以及美国食品药品监督管理局（FDA）网站，以确定所有输血传播巴贝斯虫病（TTB）的病例。针对基础疾病状况、年龄、脾脏情况以及与5类受者结局严重程度相关的输血原因对病例进行了分析。67篇报告包含256例输血病例，其中献血者微小巴贝斯虫检测呈阳性，165例导致了输血传播巴贝斯虫病。60名受者未发病或检测未呈阳性，另有31名受者的检测结果未知。165例输血传播巴贝斯虫病病例涉及血液系统疾病患者（19%）、新生儿（10%）、心血管疾病患者（8%）和胃肠道疾病患者（6%）。165例感染患者中有32例（19%）死亡，其中25例的死亡归因于巴贝斯虫病。9例（5%）无症状，27例（16%）有症状但病情不复杂，16例（10%）有复杂病情。许多疾病类别中疾病严重程度各不相同。65岁以上的患者是受者中数量最多的群体（59/165，36%），也是死亡患者中数量最多的群体（11/32, 34%），不过其他年龄组也有死亡病例。输血传播巴贝斯虫病病例主要由红细胞引起（140份指定单位中有133份），红细胞单位以各种方式处理且处于所有储存时长。患有复杂巴贝斯虫病和/或死亡的输血传播巴贝斯虫病病例发生在所有年龄组以及患有各种基础疾病的患者中。
