Bacteria in blood for transfusion. A review.

OBJECTIVE: To summarize reports of bacterial contamination of blood components for transfusion during this century, considering implicated microorganisms and patient outcomes, with identification and discussion of recommended methods to reduce or eliminate this problem. DATA SOURCES: Articles published in the English-language literature from which summary tables of all reported bacterial infections were prepared by collating published case reports, including fatalities, emphasizing recent concerns about Yersinia contamination. STUDY SELECTION: All case reports and related review articles relevant to issues about bacteria implicated in transfusion-associated sepsis were included. DATA EXTRACTION: The author personally extracted all data. DATA SYNTHESIS: With the exception of Yersinia species and Campylobacter jejuni in red blood cells and Salmonella heidelburg in platelets, the majority of bacteria implicated continue to be those found in the environment and as normal skin flora. Existing measures to identify contaminated components before transfusing them are inadequate. Manufacturing efforts to sterilize these components by various methods may result in greater benefit than those directed toward preventing contamination during collections.
CONCLUSIONS: Bacterial contamination remains a problem for transfusion medicine. Active research should continue to focus on elimination of contaminants by filtration, chemical additives, or irradiation, as well as innovative measures to detect and exclude infected units from transfusion.