Bacterial contamination and sepsis associated with transfusion: current status in latin america

Michel Andres Garcia Otalora; Rita Martins; María Isabel Bermúdez-Forero

doi:10.21037/aob-20-92

Bacterial contamination and sepsis associated with transfusion: current status in latin america

Título traducido de la contribución: Contaminación bacteriana y sepsis asociada a la transfusión: Estado actual en latinoamérica

Michel Andres Garcia Otalora
, Rita Martins
, María Isabel Bermúdez-Forero

Producción científica: Contribución a revista › Artículo de revisión › revisión exhaustiva

7 Citas (Scopus)

366 Descargas (Pure)

Resumen

En 2016 y 2017, dieciocho países latinoamericanos transfundieron 21.808.541 componentes sanguíneos, 55,9% correspondió a glóbulos rojos y 20,1% a concentrados de plaquetas. En el mismo período, solo Brasil reportó a la Organización Panamericana de la Salud (OPS) seis casos de sepsis por contaminación bacteriana (CB; cuatro en 2016 y dos en 2017). Estos datos representan una frecuencia de un caso por cada 3.634.756 componentes sanguíneos transfundidos. Estos resultados contrastan con los notificados por los informes de hemovigilancia de América del Norte, Europa, África y Oceanía, donde la frecuencia de infección bacteriana transmitida por transfusión (TTBI) oscila entre 1:14.515 y 1:384.903 en plaquetas transfundidas, y entre 1:96.850 y 1:3.448.275 en eritrocitos transfundidos. En la actualidad, la frecuencia de las TTBI es superior a la de las infecciones víricas. Aunque estrategias como el desvío de la primera alícuota, la detección bacteriana durante el almacenamiento y las tecnologías de reducción de patógenos (PRT) reducen el riesgo de TTBI, no lo eliminan. Esta revisión tiene como objetivo establecer las estrategias implementadas para reducir la TTBI en los países latinoamericanos y conocer el número de casos registrados. Asimismo, determinamos las limitaciones que impiden la notificación de TTBI. Finalmente, estimamos el número de eventos que deberían ser presentados en base a programas de hemovigilancia con mayor experiencia. Las estrategias de mitigación de la TTBI varían dentro de cada país y en toda la región latinoamericana. Hay bancos de sangre que aún no han implementado el desvío de la primera alícuota. En general, ningún país realiza el cribado mediante cultivo microbiológico del 100% de sus unidades de plaquetas recolectadas. Los PRT se utilizan solo en algunos bancos de sangre privados y públicos. Entre 2018-2020, Brasil notificó 29 TTBI (7 definitivos, 10 probables y 12 posibles), mientras que Colombia registró cuatro en 2020 (tres definitivos y uno probable). Otros países latinoamericanos no han notificado casos. Identificamos varias causas de la baja notificación de reacciones adversas a la transfusión (RAM), no sólo las relacionadas con las TTBI. Estimamos que la subnotificación de TTBI en los países latinoamericanos oscila entre 7 y 29 veces en comparación con los datos de programas sólidos de hemovigilancia. Es importante destacar que varios países carecen de coordinación nacional para recopilar, analizar y proporcionar información a las partes interesadas. Por último, no existe una auditoría externa que garantice la adopción de definiciones y procesos estándar relacionados con la hemovigilancia en los países latinoamericanos.

Título traducido de la contribución	Contaminación bacteriana y sepsis asociada a la transfusión: Estado actual en latinoamérica
Idioma original	Inglés estadounidense
Número de artículo	1
Páginas (desde-hasta)	1-18
Número de páginas	18
Publicación	Annals of Blood
Volumen	6
N.º	1
DOI	https://doi.org/10.21037/aob-20-92
Estado	Publicada - sep. 30 2021

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ODS 3: Salud y bienestar

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Medicina (miscelánea)

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title = "Bacterial contamination and sepsis associated with transfusion: current status in latin america",

abstract = "In 2016 and 2017, eighteen Latin American countries transfused 21,808,541 blood components, 55.9\% corresponded to red blood cells and 20.1\% to platelet concentrates. In the same period, only Brazil reported to the Pan American Health Organization (PAHO) six cases of sepsis due to bacterial contamination (BC; four in 2016 and two in 2017). These data represent a frequency of one case per 3,634,756 transfused blood components. These results contrast with those notified by the haemovigilance reports from North America, Europe, Africa, and Oceania, where transmitted-transfusion bacterial infection (TTBI) frequency range 1:14,515 to 1:384,903 in transfused platelets, and 1:96,850 to 1:3,448,275 in transfused erythrocytes. Today{\textquoteright}s frequency of TTBI is higher than viral infections. Although strategies such as diversion of the first aliquot, bacterial detection during storage, and pathogen reduction technologies (PRT) reduce the risk of TTBI, they do not eliminate it. This review aims to establish the strategies implemented to reduce TTBI in Latin American countries and know the number of cases recorded. Likewise, we determined the limitations that prevent TTBI notification. Finally, we estimated the number of events that should be presented based on more experienced haemovigilance programs. TTBI mitigation strategies vary within each country and throughout the Latin American region. There are blood banks that have not yet implemented the diversion of the first aliquot. In general, no country performs microbiological culture screening of 100\% of its collected platelet units. PRT are used only in some private and public blood banks. Between 2018–2020, Brazil reported 29 TTBI (7 definitive, 10 probable, and 12 possible), while Colombia registered four in 2020 (three definitive and one probable). Other Latin American countries have not reported cases. We identified several causes of low notification of adverse transfusion reactions (ADRs), not only those related to TTBI. We estimated that the underreporting of TTBI in Latin American countries ranges from 7 to 29-fold compared to data of robust haemovigilance programs. Importantly, several countries lack national coordination to collect, analyze, and provide feedback to stakeholders. Finally, there is no external audit to guarantee the adoption of standard definitions and processes related to haemovigilance in Latin American countries. ",

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T1 - Bacterial contamination and sepsis associated with transfusion: current status in latin america

AU - Garcia Otalora, Michel Andres

AU - Martins, Rita

AU - Bermúdez-Forero, María Isabel

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Y1 - 2021/9/30

N2 - In 2016 and 2017, eighteen Latin American countries transfused 21,808,541 blood components, 55.9% corresponded to red blood cells and 20.1% to platelet concentrates. In the same period, only Brazil reported to the Pan American Health Organization (PAHO) six cases of sepsis due to bacterial contamination (BC; four in 2016 and two in 2017). These data represent a frequency of one case per 3,634,756 transfused blood components. These results contrast with those notified by the haemovigilance reports from North America, Europe, Africa, and Oceania, where transmitted-transfusion bacterial infection (TTBI) frequency range 1:14,515 to 1:384,903 in transfused platelets, and 1:96,850 to 1:3,448,275 in transfused erythrocytes. Today’s frequency of TTBI is higher than viral infections. Although strategies such as diversion of the first aliquot, bacterial detection during storage, and pathogen reduction technologies (PRT) reduce the risk of TTBI, they do not eliminate it. This review aims to establish the strategies implemented to reduce TTBI in Latin American countries and know the number of cases recorded. Likewise, we determined the limitations that prevent TTBI notification. Finally, we estimated the number of events that should be presented based on more experienced haemovigilance programs. TTBI mitigation strategies vary within each country and throughout the Latin American region. There are blood banks that have not yet implemented the diversion of the first aliquot. In general, no country performs microbiological culture screening of 100% of its collected platelet units. PRT are used only in some private and public blood banks. Between 2018–2020, Brazil reported 29 TTBI (7 definitive, 10 probable, and 12 possible), while Colombia registered four in 2020 (three definitive and one probable). Other Latin American countries have not reported cases. We identified several causes of low notification of adverse transfusion reactions (ADRs), not only those related to TTBI. We estimated that the underreporting of TTBI in Latin American countries ranges from 7 to 29-fold compared to data of robust haemovigilance programs. Importantly, several countries lack national coordination to collect, analyze, and provide feedback to stakeholders. Finally, there is no external audit to guarantee the adoption of standard definitions and processes related to haemovigilance in Latin American countries.

AB - In 2016 and 2017, eighteen Latin American countries transfused 21,808,541 blood components, 55.9% corresponded to red blood cells and 20.1% to platelet concentrates. In the same period, only Brazil reported to the Pan American Health Organization (PAHO) six cases of sepsis due to bacterial contamination (BC; four in 2016 and two in 2017). These data represent a frequency of one case per 3,634,756 transfused blood components. These results contrast with those notified by the haemovigilance reports from North America, Europe, Africa, and Oceania, where transmitted-transfusion bacterial infection (TTBI) frequency range 1:14,515 to 1:384,903 in transfused platelets, and 1:96,850 to 1:3,448,275 in transfused erythrocytes. Today’s frequency of TTBI is higher than viral infections. Although strategies such as diversion of the first aliquot, bacterial detection during storage, and pathogen reduction technologies (PRT) reduce the risk of TTBI, they do not eliminate it. This review aims to establish the strategies implemented to reduce TTBI in Latin American countries and know the number of cases recorded. Likewise, we determined the limitations that prevent TTBI notification. Finally, we estimated the number of events that should be presented based on more experienced haemovigilance programs. TTBI mitigation strategies vary within each country and throughout the Latin American region. There are blood banks that have not yet implemented the diversion of the first aliquot. In general, no country performs microbiological culture screening of 100% of its collected platelet units. PRT are used only in some private and public blood banks. Between 2018–2020, Brazil reported 29 TTBI (7 definitive, 10 probable, and 12 possible), while Colombia registered four in 2020 (three definitive and one probable). Other Latin American countries have not reported cases. We identified several causes of low notification of adverse transfusion reactions (ADRs), not only those related to TTBI. We estimated that the underreporting of TTBI in Latin American countries ranges from 7 to 29-fold compared to data of robust haemovigilance programs. Importantly, several countries lack national coordination to collect, analyze, and provide feedback to stakeholders. Finally, there is no external audit to guarantee the adoption of standard definitions and processes related to haemovigilance in Latin American countries.

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DO - 10.21037/aob-20-92

M3 - Review article

SN - 2521-361X

VL - 6

SP - 1

EP - 18

JO - Annals of Blood

JF - Annals of Blood

IS - 1

M1 - 1

ER -

Bacterial contamination and sepsis associated with transfusion: current status in latin america

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