What is the risk of transfusion-related bacterial sepsis?

Updated: Apr 16, 2019
  • Author: Linda L Maerz, MD, FACS, FCCM; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Bacterial contamination is responsible for at least 10% of transfusion-associated deaths and most infection-related deaths.  The risk of symptomatic bacterial sepsis per unit of PRBC is 1:250,000.  The risk of death from bacterial sepsis per unit of PRBC is 1:500,000. [39] Yersiniaenterocolitica is the most common bacterial contaminant of PRBC; other pathogens include Serratiamarcescens, Pseudomonasaeruginosa, and Enterobacter species. Incidence is directly related to the length of storage.

Platelet-related sepsis is even more common. The risk of symptomatic bacterial sepsis per pool of platelets is 1:10,000.  The risk of death from bacterial sepsis per pool of platelets is 1:200,000. [39] Risk is greatest in transfusion of pooled platelet concentrates from multiple donors when compared to single-donor platelet transfusion. Because the risk increases with time, the shelf life of stored platelets should not exceed 5 days. Typical pathogens include Staphylococcusaureus and Staphylococcusepidermidis. Therefore, sepsis following platelet transfusion may be unrecognized, since these are common pathogens and infection may be attributed to other sources, such as device-related blood stream infections.


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