Klebsiella oxytoca bacteremia following platelet transfusions.

Two fractions of a three-day-old apheresis platelet collection from a known habitual donor were transfused to two children with thrombocytopenia and b leeding. Both patients developed evidence of severe infection during the tr ansfusion. One died despite intensive care and antimicrobial therapy. The o ther, whose transfusion was cut short, recovered. A Klebsiella oxytoca stra in was recovered from the two transfusion bags, from a third unused bag, an d from blood samples from the patient who died. Genotyping results establis hed that all these isolates were identical. Tests for K. oxytoca were negat ive on the batches of blood donation material, the bottle of antiseptic use d and throat and stool specimens from the donor and phlebotomists. The most likely hypothesis is that the donor developed transient asymptomatic bacte remia during the 136-minute-long collection procedure and that the organism subsequently grew in the platelet collections, which were kept at 20-24 de grees C with agitation for three days before being used.