Summer Buzz

Polyxeni Potter

Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Psychrobacter arenosus Bacteremia after Blood Transfusion, France

Yvan Caspar

, Christine Recule, Patricia Pouzol, Bruno Lafeuillade, Marie-Reine Mallaret, Max Maurin, and Jacques Croize

Author affiliations: Centre Hospitalier Universitaire de Grenoble, Grenoble, France (Y. Caspar, C. Recule, P. Pouzol, M.-R. Mallaret, M. Maurin, J. Croize); Université Joseph Fourier-Grenoble 1, Grenoble, France (Y. Caspar, C. Recule, P. Pouzol, M.-R. Mallaret, M. Maurin, J. Croize); Etablissement Français du Sang, La Tronche, France (B. Lafeuillade)

Abstract

We report a case of transfusion-associated bacteremia caused by Psychrobacter arenosus. This psychrotolerant bacterium was previously isolated in 2004 from coastal sea ice and sediments in the Sea of Japan, but not from humans. P. arenosus should be considered a psychrotolerant bacterial species that can cause transfusion-transmitted bacterial infections.

Bacteria are the leading cause of transfusion-transmitted infections (1). Contamination occurs more frequently in platelet concentrates than in erythrocyte units, especially because of different storage conditions (20°C–24°C for platelet concentrates vs. 1°C–6°C for erythrocyte units). However, several bacterial species are able to grow at 4°C (1–3). We report a case of transfusion-transmitted bacterial infection caused by Psychrobacter arenosus, an environmental psychrotolerant and halotolerant bacterium.

The Patient

In October 2009, a 58-year-old man was admitted to Grenoble University Hospital (Grenoble, France) for a blood transfusion because of severe anemia. Idiopathic medullary aplasia had been diagnosed in 1997, and he had had grade 3 myelofibrosis since 2006. He had been receiving palliative care since November 2007, and received transfusions of erythrocyte units every 3 weeks. On October 27, 2009, he received 3 erythrocyte units (at 8:30 am, 10:30 am, and 12:15 pm). While receiving the third unit, he became febrile (temperature of 38°C that rapidly increased to 40°C) and had chills and headache. The transfusion was stopped and the patient transferred to the Department of Internal Medicine. At examination, there was no hypotension, jaundice, or red urine.
Standard laboratory testing showed no ABO incompatibility, hemoglobinemia, hemoglobinuria, and coagulation disorders. According to recommendations of the Agence Nationale de Sécurité du Médicament (Saint-Denis, France), 3 sets of aerobic and anaerobic blood cultures (Bactec; Becton Dickinson, Pont de Clay, France) for the recipient (1 immediately and 2 others 4 hours later) and the remaining part of the third erythrocyte unit were sent to the bacteriology laboratory for culture. Gram staining of a blood smear prepared from the third erythrocyte unit showed a large number (≈10⁶ CFU/mL) of gram-variable coccobacilli.