transfusion-associated infection
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Pathology
- viral transmission
- etiology: failure to recognize asymptomatic donors infected with HIV-1, HIV-2, HTLV-1, HTLV-2, hepatitis viruses, CMV, & others
- clinical manifestations: related to transmitted virus
- incidence: (risk per unit of component transfused)
- HIV: < 1 in 200,000
- hepatitis B: < 1 in 200,000
- hepatitis C: < 1 in 3000
- HTLV: < 1 in 60,000
- CMV: 50-100% of donors are infected
- HIV: < 1 in 200,000
- prevention:
- transmission of bacteria & bacterial endotoxins
- etiology:
- unrecognized bacteremia in donor
- contamination during processing
- bacterial contamination of donor platelets is the most common cause
- E. coli & Pseudomonas are associated with refrigerated components
- Yersinia, Serratia & Salmonella are associated with platelets
- clinical manifestations:
- shock & disseminated intravascular coagulation (DIC)
- high mortality
- incidence: < 1 in 500,000 as cause of death
- prevention:
- proper skin preparation with blood donation
- good blood banking practices
- deferring donors with febrile illnesses
- use of leukocyte-depleted blood components
- etiology:
- transmission of parasites
- etiology: donors infected with parasites, i.e. Plasmodium (malaria), Trypanosomes (Chagas' disease)
- clinical manifestations: related to transmitted parasite
- incidence: rare in the USA
- prevention:
- donor screening
- development of serologic tests