Bacteremia in Febrile Children With Sickle Cell Disease

Özgönenel, Bülent; Mushrif, Sujata; McGrath, Eric; Roy, Sumita; Sarnaik, Sharada A.

doi:10.1097/mph.0b013e3182831016

Cited by 2 publications

(4 citation statements)

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“…We included in our review 7 articles: Rogovik et al, 11 Narang et al, 5 Chang et al, 12 Bansil et al, 13 Patel et al, 14 Shihabuddin and Scarfi, 15 and Morrissey et al 16 ; 2 abstracts: Bleier et al, 17 and Massari and Black 18 ; and 1 letter to the editor: Ozgonenel et al 19 All 10 studies used a retrospective design with data extracted from medical records.…”

Section: Resultsmentioning

confidence: 99%

“…The 10 studies in our review included a total of 1853 patients with 4400 febrile episodes (Table S1 Supplemental Digital Content, http://links.lww.com/PEC/A478). Two studies, Shihabuddin and Scarfi 15 and Massari and Black, 18 did not specify the temperature defining their inclusion febrile episode; the other 8 used a minimum temperature between 38°C (Rogovik et al, 11 Chang et al, 12 Bansil et al, 13 Bleier et al, 17 and Ozgonenel et al 19 ) and 38.5°C (Morrissey et al 16 ). None of the studies stated their specific exclusion criteria except one, Bansil et al, 13 which excluded patients with a previous evaluation for fever in the last 1 week.…”

Section: Resultsmentioning

confidence: 99%

“…The low prevalence of bacteremia in all of our studies severely limits the power of any association or lack thereof. The study by Chang et al 12 found a significant association between the presence of a central venous line (CVL) and bacteremia, and the study by Ozgonenel et al 19 reported that the rate of bacteremia was ~21 times higher in patients with CVL compared with those without CVL. No study found an association between temperature and bacteremia.…”

Section: Resultsmentioning

confidence: 99%

“…The low prevalence of bacteremia in all of our studies severely limits the power of any association or lack thereof. The 19 reported that the rate of bacteremia was ~21 times higher in patients with CVL compared with those without CVL. No study found an association between temperature and bacteremia.…”

Section: Risk Factors For Bacteremiamentioning

confidence: 99%

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Prevalence of Bacteremia in Febrile Patients With Sickle Cell Disease

Bala¹,

Chao

John

et al. 2019

Pediatr Emer Care

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Objective: Pneumococcal vaccination has decreased the bacteremia rate in both the general pediatric and sickle cell disease (SCD) populations. Despite this decrease, and an increasing concern for antibiotic resistance, it remains standard practice to obtain blood cultures and administer antibiotics in all febrile (>38.5°C) patients with SCD. We conducted a systematic review and meta-analysis of the available studies of the prevalence of bacteremia in febrile patients with SCD. Methods:We searched the medical literature up to November 2018 in PUBMED, EMBASE, and Web of Science with terms epidemiology, prevalence, bacteremia, and sickle cell anemia. We only included studies with patients after 2000, when the pneumococcal 7-valent conjugate (PCV7) vaccine became widely available. The prevalence of bacteremia [95% confidence interval (CI)] was calculated by dividing the number of positive blood cultures by the number of febrile episodes. The I 2 statistic measured heterogeneity between prevalence estimates. Bias in our studies was quantified by the Newcastle-Ottawa Quality Assessment Scale.Results: Our search identified 228 citations with 10 studies meeting our inclusion/exclusion criteria. The weighted prevalence of bacteremia across all studies was 1.9% (95% CI, 1.22%-2.73%), and for Streptococcus pneumoniae bacteremia, it was 0.31% (95% CI, 0.16%-0.50%). Risks for bacteremia except central lines could not be determined because of the low prevalence of the outcome.Conclusions: There appears to be a need to develop a risk stratification strategy to guide physicians to manage febrile patients with SCD based on factors including, but not limited to, history and clinical examination, vaccination status, use of prophylactic antibiotics, laboratory values, likely source of infection, and accessibility to health care.

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