Bacterial-induced RBC alterations complicating necrotizing enterocolitis
R. W. Novak
Enzymes released from bacteria can alter the surfaces of RBCs rendering
them susceptible to destruction by antibodies present in a high percentage
of adult plasmas. Such RBC alterations were observed in four of 20
consecutive cases of radiologically proved necrotizing enterocolitis.
Involved infants were seriously ill, three of four demonstrating bowel
perforation. Bacteria of the genus Clostridium were isolated from blood or
peritoneal fluid in three of four affected patients and elaborated
appropriate RBC-altering enzymes in vitro. Two patients who had received
plasma-containing products experienced notable hemolysis. Patients treated
with washed products and plasma protein fractions lacking immunoglobulins
had no hemolytic problems. The alteration of the RBC membrane is easily
detected by a rapid, simple lectin agglutination test.
