Methicillin-resistant Staphylococcus aureus sepsis associated with the transfusion of contaminated platelets: a case report

BACKGROUND: Platelet transfusion-associated sepsis is usually due to donor skin flora introduced into the unit during phlebotomy. An unusual case of a platelet component contaminated with methicillin-resistant Staphylococcus aureus (MRSA) is reported. CASE REPORT: A 54-year-old man, terminally ill with progressive non-Hodgkin 's lymphoma, developed fever and hypotension during a platelet transfusion, He was receiving multiple antibiotics, including vancomycin. Blood culture s taken soon after transfusion were negative. An aliquot taken from the pla telet pool grew MRSA at a count of 1.6 x 10(8) CFUs per mL. One of the indi vidual bags constituting the pool showed MRSA at a count of 5.1 x 10(8) CFU s per mL. The patient died soon after the platelet transfusion. This case w as reported to the FDA and submitted to the BaCon Study. The identity of th e isolate and its methicillin resistance were confirmed by the CDC as part of the BaCon Study protocol. The source of contamination of the implicated unit could not be established with certainty. CONCLUSION: The emergence of antimicrobial-resistant organisms poses additi onal challenges for the diagnosis and treatment of transfusion-associated s epsis. Measures to prevent or intercept the transfusion of contaminated pla telets should be developed.