Bacterial contamination and sepsis associated with transfusion: current status in latin america: Contaminación bacteriana y sepsis asociada a la transfusión: Estado actual en latinoamérica
Artículo académico
Visión General
Visión General
Abstracto
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.
