Patricia Davenport1, Kevin J Land. 1. Department of Medical Services, Carter BloodCare, 2205 Highway 121, Bedford, TX 76021, USA. pdavenport@carterbloodcare.org
Abstract
BACKGROUND: Bacterial contamination of platelet (PLT) components is a leading cause of transfusion-related fatality. AABB and The College of American Pathologists require that blood centers and transfusion services have a process for detecting bacterial contamination in PLT products. CASE REPORT: Leclercia adecarboxylata was isolated from the donated blood of a healthy, asymptomatic 61-year-old man. The PLT donation was collected by apheresis method and was separated into three daughter or split products. Samples from all three products tested positive for the presence of bacterial contamination. L. adecarboxylata was subsequently identified in two of three products. The blood donor's records were reviewed and the donor was interviewed by telephone. The only possible risk identified during the interview was a questionable contact dermatitis, away from the antecubital fossa, thought to be due to poison ivy exposure before the donation. All subsequent donations have tested negative for the presence of bacterial contamination. The organism is a Gram-negative bacillus variant of the Enterobacteriaceae family and known nosocomial isolate. It has been previously reported as a rarely isolated opportunistic pathogen mostly associated with patients having compromised immunity, chronic or inflammatory illness, catheter-related bacteremia, or mixed-bacterial wounds. L. adecarboxylata was originally identified in water, foods, and environment. CONCLUSION: This is the first known report of isolation of L. adecarboxylata from the blood donation of an apparently healthy individual and could represent transient asymptomatic bacteremia or more likely contamination by epidermal flora. The organism may be underrecognized due to its close resemblance to Escherichia coli.
BACKGROUND: Bacterial contamination of platelet (PLT) components is a leading cause of transfusion-related fatality. AABB and The College of American Pathologists require that blood centers and transfusion services have a process for detecting bacterial contamination in PLT products. CASE REPORT: Leclercia adecarboxylata was isolated from the donated blood of a healthy, asymptomatic 61-year-old man. The PLT donation was collected by apheresis method and was separated into three daughter or split products. Samples from all three products tested positive for the presence of bacterial contamination. L. adecarboxylata was subsequently identified in two of three products. The blood donor's records were reviewed and the donor was interviewed by telephone. The only possible risk identified during the interview was a questionable contact dermatitis, away from the antecubital fossa, thought to be due to poison ivy exposure before the donation. All subsequent donations have tested negative for the presence of bacterial contamination. The organism is a Gram-negative bacillus variant of the Enterobacteriaceae family and known nosocomial isolate. It has been previously reported as a rarely isolated opportunistic pathogen mostly associated with patients having compromised immunity, chronic or inflammatory illness, catheter-related bacteremia, or mixed-bacterial wounds. L. adecarboxylata was originally identified in water, foods, and environment. CONCLUSION: This is the first known report of isolation of L. adecarboxylata from the blood donation of an apparently healthy individual and could represent transient asymptomatic bacteremia or more likely contamination by epidermal flora. The organism may be underrecognized due to its close resemblance to Escherichia coli.