February 1986

Escherichia coli Sepsis From Contaminated Platelet Transfusion

Author Affiliations

From the Departments of Medicine (Drs Arnow and Weiss) and Pathology (Dr Rosen), and the Infection Surveillance Program (Dr Arnow and Ms Weil), University of Chicago Hospitals and Clinics.

Arch Intern Med. 1986;146(2):321-324. doi:10.1001/archinte.1986.00360140147021

• Transfusion of pooled platelet concentrate (PC) caused a septic reaction characterized by sustained hypotension, high cardiac output, and low systemic vascular resistance. Investigation demonstrated the same strain of Escherichia coli in the patient's blood, the transfused pooled PC, and recalled packed red blood cells separated from the same unit of whole blood as one of the platelet units in the contaminated pool. Five hundred other units of PC from the same supplier were cultured prospectively, and 7% were bacterially contaminated. The level of contamination was 20 or fewer colony-forming units per milliliter in all except one unit, the only one associated with a febrile transfusion reaction. This episode illustrates the continuing importance of sepsis as a cause of platelet transfusion reactions and demonstrates the usefulness of appropriate cultures and epidemiologic information in assessing the source.

(Arch Intern Med 1986;146:321-324)