Transfusion Reaction Work-ups

[mrmic]

I am curious to find out what methods other Microbiology Labs are using for investigating Transfusion Reactions for the Blood Bank Transfusion Service?  Limited verbal communications suggest there are a lot of variations out there.   Based on product, how do you screen for Salmonella, etc., Staph aureus, Yeast or Yersinia?   Currently, the ways its has been handed down for X years, is that we inoculate three Thio broth tubes and incubate them at 4C, 22C, and 35-37C for 5 days.   If there is any growth we, gram stain and sub to appropriate media plates.     I am a little concerned if this is still adequate, esp for Yersinia spp.   What does your Blood Bank Transfusion Service "think" you are screening for? 

Thanks

[donellda]

If you have enough of the unit left, you could use blood culture vials along with an initial gram stain.

[SbbPerson ★]

If bacterial contamination is suspected due to the signs/symptoms of the patient(high fever, vomitting, tachycardia, etc..) and/or discoloration of the blood product, an initial gram stain is performed and 4 plates are inoculated with the blood, Blood agar, chocalate, mackonkey, and an anaerobic plate. Then we go from there.

 

Not sure about the reasoning of incubating the broth at 4 degrees C.  Is that to rule in/out a cold agglutinin? 

[Malcolm Needs ★]

11 hours ago, SbbPerson said:

If bacterial contamination is suspected due to the signs/symptoms of the patient(high fever, vomitting, tachycardia, etc..) and/or discoloration of the blood product, an initial gram stain is performed and 4 plates are inoculated with the blood, Blood agar, chocalate, mackonkey, and an anaerobic plate. Then we go from there.

I sincerely hope that you would also contact your blood supplier to let them know that there is a high risk of bacterial infection, as there may well be other blood components from the same donor that may yet still be untransfused to a patient, and which should be immediately put into quarantine.