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血小板采集套装生产设施中细菌污染导致的输血后脓毒症,美国。

Posttransfusion Sepsis Attributable to Bacterial Contamination in Platelet Collection Set Manufacturing Facility, United States.

出版信息

Emerg Infect Dis. 2023 Oct;29(10):1979-1989. doi: 10.3201/eid2910.230869. Epub 2023 Aug 10.

Abstract

During May 2018‒December 2022, we reviewed transfusion-transmitted sepsis cases in the United States attributable to polymicrobial contaminated apheresis platelet components, including Acinetobacter calcoaceticus‒baumannii complex or Staphylococcus saprophyticus isolated from patients and components. Transfused platelet components underwent bacterial risk control strategies (primary culture, pathogen reduction or primary culture, and secondary rapid test) before transfusion. Environmental samples were collected from a platelet collection set manufacturing facility. Seven sepsis cases from 6 platelet donations from 6 different donors were identified in patients from 6 states; 3 patients died. Cultures identified Acinetobacter calcoaceticus‒baumannii complex in 6 patients and 6 transfused platelets, S. saprophyticus in 4 patients and 4 transfused platelets. Whole-genome sequencing showed environmental isolates from the manufacturer were closely related genetically to patient and platelet isolates, indicating the manufacturer was the most probable source of recurrent polymicrobial contamination. Clinicians should maintain awareness of possible transfusion-transmitted sepsis even when using bacterial risk control strategies.

摘要

在 2018 年 5 月至 2022 年 12 月期间,我们审查了归因于多微生物污染的单采血小板成分的输血相关败血症病例,包括从患者和成分中分离出的鲍曼不动杆菌复合菌或腐生葡萄球菌。在输血前,输注的血小板成分经过了细菌风险控制策略(初级培养、病原体减少或初级培养和二级快速检测)。从血小板采集套件制造设施收集了环境样本。从 6 个不同供体的 6 个血小板供体中发现了 6 个州的 7 个败血症病例;3 名患者死亡。培养鉴定出 6 名患者和 6 份输注血小板中有鲍曼不动杆菌复合菌,4 名患者和 4 份输注血小板中有腐生葡萄球菌。全基因组测序显示,制造商的环境分离株与患者和血小板分离株在遗传上密切相关,表明制造商是反复多微生物污染的最可能来源。临床医生应即使在使用细菌风险控制策略时,也要保持对可能发生的输血相关败血症的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2921/10521617/43791d781e04/23-0869-F1.jpg

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