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Unrelated bone marrow as a source of Bacillus cereus causing septic shock

Bone Marrow Transplantation volume 26, pages 1259–1260 (2000)Cite this article

Bone marrow grafts are commonly found to host bacteria diagnosed by surveillance culture, and graft contamination can be found in 2%1 to 25%2 of samples. In a retrospective 10 year evaluation of the prevalence of marrow contamination in our service, a 15.2% contamination rate was noted. However, studies have consistently reported no clinical impact due to this fact.34 Recently, we faced a situation that led us to rethink our position about graft contamination.

An 18-year-old male with the diagnosis of acute biphenotypic leukemia received an unrelated bone marrow transplantation. The donor was selected through the National Marrow Donor Program and the marrow harvested in USA. A courier transported the marrow in a cooler at room temperature to our service in Curitiba, Brazil. In our Cryobiology Laboratory, the volume of marrow and media was reduced from 1047 ml to 700 ml, and samples collected before and after processing were sent for cultures. In the BM Unit, 4 h after the beginning of the infusion the patient developed fever (40°C) and chills. Blood culture sets were collected, and imipenem-cilastatin started intravenously. Nine hours after fever and chills, hypotension and shock developed, being managed with vasoactive drugs. The sequence of events is detailed in Table 1.

Table 1  Sequence of events
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References

  1. Padley D, Koontz F, Trigg ME et al. Bacterial contamination rates following processing of bone marrow and peripheral blood progenitor cell preparations Transfusion 1996 36: 53–56

    Article  CAS  Google Scholar 

  2. Rowley SD, Davis J, Dick J et al. Bacterial contamination of bone marrow grafts intended for autologous and allogeneic bone marrow transplantation. Incidence and clinical significance Transfusion 1988 28: 109–112

    Article  CAS  Google Scholar 

  3. Lazarus HM, Magalhaes-Silverman M, Fox RM et al. Contamination during in vitro processing of bone marrow for transplantation: clinical significance Bone Marrow Transplant 1991 7: 241–246

    CAS  PubMed  Google Scholar 

  4. Schwella N, Zimmermann R, Heuft HG et al. Microbiologic contamination of peripheral blood stem cell autografts Vox Sang 1994 67: 32–35

    Article  CAS  Google Scholar 

  5. Webb IJ, Coral FS, Andersen JW et al. Sources and sequelae of bacterial contamination of hematopoietic stem cell components: implications for the safety of hematotherapy and graft engineering Transfusion 1996 36: 782–788

    Article  CAS  Google Scholar 

  6. Prince HM, Page SR, Keating A et al. Microbial contamination of harvested bone marrow and peripheral blood Bone Marrow Transplant 1995 15: 87–91

    CAS  PubMed  Google Scholar 

  7. Yomtovian R, Lazarus HM, Goodnough LT et al. A prospective microbiologic surveillance program to detect and prevent the transfusion of bacterially contaminated platelets Transfusion 1993 33: 902–909

    Article  CAS  Google Scholar 

  8. Osterholm MT . Emerging infections – another warning New Engl J Med 2000 342: 1280–1281

    Article  CAS  Google Scholar 

  9. Sugrue MW, Hutcheson CE, Fisk DD et al. The effect of overnight storage of leukapheresis stem cell products on cell viability, recovery, and cost J Hematother 1998 7: 431–436

    Article  CAS  Google Scholar 

  10. Gagnon JA, Porter K, Guerin D, Gluck S . Bacterial decontamination of blood stem cell apheresis product J Clin Apheresis 1998 13: 103–107

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Bone Marrow Transplantation Service, Hospital de Clinicas, Rua General Carneiro, 181–15° andar –, Curitiba, Parana, ZipCode 80060-900, UFPR, Brazil

    CR de Medeiros, LN Faoro, ML Friedrich & R Pasquini

  2. Immunogenetics Laboratory, Hospital de Clinicas, Rua General Carneiro, 181–15° andar, Curitiba, Parana, ZipCode 80060-900, UFPR, Brazil

    N Pereira

  3. Infectious Disease Branch, Hospital de Clinicas, Rua General Carneiro, 181–15° andar, Curitiba, Parana, ZipCode 80060-900, UFPR, Brazil

    CA Cunha

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  1. CR de Medeiros
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  2. LN Faoro
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  5. CA Cunha
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  6. R Pasquini
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de Medeiros, C., Faoro, L., Friedrich, M. et al. Unrelated bone marrow as a source of Bacillus cereus causing septic shock. Bone Marrow Transplant 26, 1259–1260 (2000). https://doi.org/10.1038/sj.bmt.1702704

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