Morbidity among child travellers with sickle-cell disease visiting tropical areas: an observational study in a French tertiary care centre

Sommet, Julie; Missud, Florence; Holvoet, Laurent; Ithier, Ghislaine; Lorrot, Mathie; Benkerrou, Malika; Faye, Albert

doi:10.1136/archdischild-2012-302500

Cited by 14 publications

(14 citation statements)

References 7 publications

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“…The hospitalisation and consultation rates for exacerbations in children with CHDs during the month after travel were higher than those during the month before travel. The difference was not significant, probably because of the small number of patients and events, but our results are in accordance with those of a previous study in which the hospitalisation rates of children with SCD increased after travel 6. The risk of exacerbations after returning from travel is still poorly discussed during pretravel consultations.…”

Section: Discussionsupporting

confidence: 88%

“…Among the children with SCD, the hospitalisation rate during the period following the return was 17%. Previous studies have reported similar rates: between 9.6% and 30.7% 6 7. One child with a CHD died during travel, the child had recently received a genetic diagnosis of atypical HUS and had never had any manifestations of the disease before the trip.…”

Section: Discussionsupporting

confidence: 55%

“…This incidence is even higher among adults with chronic health disorders (CHDs), resulting in both an increased risk of infection and a high proportion of problems related to chronic conditions 4 5. However, data regarding health problems among children with CHDs travelling abroad are limited 6 7…”

Section: Introductionmentioning

confidence: 99%

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Children with chronic health disorders travelling to the tropics: a prospective observational study

Ducrocq¹,

Sommet

Levy³

et al. 2016

Arch Dis Child

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 55%

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Children with chronic health disorders travelling to the tropics: a prospective observational study

Ducrocq¹,

Sommet

Levy³

et al. 2016

Arch Dis Child

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“…These include disorders of oxidative cellular killing, such as chronic granulomatous disease, in which nontyphoidal Salmonella is described as the most common cause of bloodstream infection and the third leading cause of all infections (151). Children who are homozygous for sickle cell disease are susceptible to invasive nontyphoidal Salmonella infections (152). In addition, inherited deficiencies of cytokines that are known to be critical for intracellular killing, particularly interleukin-12 (IL-12) and IL-23, are associated with invasive nontyphoidal Salmonella (153).…”

Section: Nontyphoidal Salmonellamentioning

confidence: 99%

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

et al. 2015

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SUMMARY Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica , initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015.

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“…These include chronic granulomatous disease (a defect of oxidative cellular killing [35], and inherited deficiencies of cytokines that are known to be critical for intracellular killing, particularly IL12 and IL23. Children homozygous for sickle cell disease are also extremely susceptible to iNTS infections [36,37], while heterozygosity for the sickle cell gene is protective against invasive Gram negative infections, including iNTS disease, most likely through a protective effect against malaria [38].…”

Section: Invasive Non-typhoidal Salmonella (Ints) Diseasementioning

confidence: 99%

Antimicrobial resistance and management of invasive Salmonella disease

Kariuki¹,

Gordon²,

Feasey³

et al. 2015

Vaccine

245

202

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Invasive Salmonella infections (typhoidal and non-typhoidal) cause a huge burden of illness estimated at nearly 3.4 million cases and over 600,000 deaths annually especially in resource-limited settings. Invasive non-typhoidal Salmonella (iNTS) infections are particularly important in immunosuppressed populations especially in sub-Saharan Africa, causing a mortality of 20–30% in vulnerable children below 5 years of age. In these settings, where routine surveillance for antimicrobial resistance is rare or non-existent, reports of 50–75% multidrug resistance (MDR) in NTS are common, including strains of NTS also resistant to flouroquinolones and 3rd generation cephalosporins. Typhoid (enteric) fever caused by Salmonella Typhi and Salmonella Paratyphi A remains a major public health problem in many parts of Asia and Africa. Currently over a third of isolates in many endemic areas are MDR, and diminished susceptibility or resistance to fluoroquinolones, the drugs of choice for MDR cases over the last decade is an increasing problem. The situation is particularly worrying in resource-limited settings where the few remaining effective antimicrobials are either unavailable or altogether too expensive to be afforded by either the general public or by public health services. Although the prudent use of effective antimicrobials, improved hygiene and sanitation and the discovery of new antimicrobial agents may offer hope for the management of invasive salmonella infections, it is essential to consider other interventions including the wider use of WHO recommended typhoid vaccines and the acceleration of trials for novel iNTS vaccines. The main objective of this review is to describe existing data on the prevalence and epidemiology of antimicrobial resistant invasive Salmonella infections and how this affects the management of these infections, especially in endemic developing countries.

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Morbidity among child travellers with sickle-cell disease visiting tropical areas: an observational study in a French tertiary care centre

Abstract: Travels to tropical areas are associated with high morbidity in children with SCD. Salmonella infection is a particularly significant threat, and empirical antibiotic therapy should be prescribed routinely for traveller's diarrhoea in this population.

Cited by 14 publications

References 7 publications

Children with chronic health disorders travelling to the tropics: a prospective observational study

Children with chronic health disorders travelling to the tropics: a prospective observational study

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

Antimicrobial resistance and management of invasive Salmonella disease

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