Management of Micrococcus Contamination in Transfused Blood

Immediate Actions

The American College of Physicians and other medical societies recommend stopping the transfusion immediately upon suspecting bacterial contamination, which may present as fever, chills, hypotension, or other signs of a transfusion reaction, and obtaining blood cultures from both the patient and the blood product 2
The Infectious Diseases Society of America recommends maintaining intravenous access with normal saline for medication administration and fluid resuscitation, and contacting the transfusion laboratory immediately to send the blood unit with administration set for investigation 1
The Journal of Clinical Oncology suggests obtaining blood cultures from the patient and from the suspected contaminated blood product 2

The Centers for Disease Control and Prevention recommend that diagnosis of catheter-related bloodstream infection (CRBSI) due to Micrococcus requires at least 2 positive results of blood cultures performed on samples obtained from different sites 1
The American Thoracic Society recommends aseptic collection of as much body fluid as possible by needle aspiration or surgical procedures for accurate diagnosis 4

The American College of Cardiology recommends initiating empiric antibiotic therapy promptly, especially in neutropenic patients, and removing the catheter if the patient has a short-term central venous catheter (CVC) or an infected long-term catheter or implanted port 1, 2

The American Association of Blood Banks recommends that blood banks implement measures to reduce the risk of bacterial contamination, including improved donor skin disinfection, and using commercial methods of pathogen reduction using UV irradiation after incubation with a photosensitizer 2
The European Centre for Disease Prevention and Control suggests limiting storage time from collection to transfusion to 5 days, though in some jurisdictions this can be extended to 7 days if approved tests for bacterial detection or pathogen reduction technologies are used 2

The Centers for Disease Control and Prevention recommend that suspected transfusion-associated transmission of bacterial contamination should be reported as early as possible to the blood product supplier and public health authorities, and that early reporting is essential in facilitating timely tracking and quarantining of potentially infectious co-components and notification of the infected donor and blood product recipients 5