[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]
Volume 25, Number 8—August 2019 / Synopsis
Pseudomonas poae–Associated Fatal Septic Transfusion Reaction, Peoria, Illinois, USA, 2017
Therese S. Woodring and John J. Farrell
Author affiliations: University of Illinois College of Medicine, Peoria, Illinois, USA (T.S. Woodring, J.J. Farrell); OSF System Laboratory, Peoria (J.J. Farrell)
In the United States, fatal transfusion-transmitted infections from red blood cell units are rare. Although this pattern mostly reflects how inhospitable refrigerated red blood cell units are to contaminant growth, fatalities caused by microorganisms that can grow at storage temperature (4°C), but not in standard clinical blood cultures at 37°C, are probably underestimated. We analyzed a fatal red blood cell transfusion in Peoria, Illinois, USA, that occurred in 2017. Samples from the patient’s whole blood and the red blood cell unit remained culture-negative during the investigation, despite direct visualization of gram-negative bacilli within the unit immediately after transfusion. We identified the bacteria as Pseudomonas poae, a nonpathogenic pseudomonad carrying multiple cold-shock domain protein genes, and confirmed its cold tolerance and inability to grow at 37°C. Our work indicates transfusion reaction workups need to include testing for psychrophilic organisms, which could explain the cause of other apparently culture-negative transfusion reactions.
Keywords: Blood safety; Pseudomonas poae; USA; Illinois.