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Sepsis and Surveillance

Committed to Blood Safety for Your Patients

Frequency of Contamination

  • An estimated 1:1,500 platelet units may contain bacteria1.
  • During treatment cycles where six units of platelets are transfused, the risk of a patient receiving a contaminated unit may be ~1:250 to 1:4001,5
  • Assuming an active surveillance (vs. passive surveillance) of sepsis occurrence, rates of sepsis risk can be ~1:5,000 units, or about 1:1,000 per patient risk.7
Bacterial Contamination
Risk
bag ~1:1,500 Units
to
~1:2,500 Units1,5
Patient ~1:250
to
~1:400 Patients5,7
Known / Unknown Viral and Parasite Infectious Risk
bag Zika
Yellow Fever
Babesia
Patient Chikungunya
Dengue
Plasmodium

Transfusion Related Sepsis is Underreported Due To Passive vs. Active Surveillance Methods

  • Bacterial contamination of platelets is an ongoing issue…1-6
  • …but passive surveillance using diagnostic criteria for septic transfusion reactions rarely identifies these events5
  • Over 10 years of active surveillance at a major academic institution, patients continued to receive bacterially-contaminated platelets yet all resulting septic transfusion reactions were missed.5

Active Surveillance: 2007-2013, University Hospitals Case Medical Center5:

51,440 platelet units transfused – all negative by culture

20 out of 51,440 (~1:2,500) transfused platelet units were contaminated with bacteria

5 out of 20 patients who received contaminated platelets developed a septic transfusion reaction 9-24 hours post transfusion.


None of these reactions were reported by passive surveillance.

1.Dumont, LJ et al. Transfusion. 2010 Mar;50(3):589–99. 2.Pearce, S et al. Transfus Med. 2011 Feb;21(1):25–32.  3.Murphy, WG et al. Vox Sang. 2008 Jul;95(1)13–9.  4.Walther-Wenke, G et al. Vox Sang. 2011 May;100(4):359–66.  5.Hong H, et al. Blood. 2016;127(4):496-502.  6.FDA. Bacterial Risk Control Strategies for Blood Collection Establishments and Transfusion Services to Enhance the Safety and Availability of Platelets for Transfusion: Guidance for Industry. In: CBER, ed. Silver Spring, MD: US Food and Drug Administration; Dec 2020  7. Kleinman S, et al. Transfusion 2013;53:1603-18.