Prevalence of Serious Bacterial Infections in Children With Sickle Cell Disease at King Abdulaziz Hospital, Al Ahsa

Abstract

Aim: The main aim was to report the prevalence and severity of serious bacterial infections (SBI) in children with sickle cell disease at King Abdulaziz Hospital, Al Ahsa, Saudi Arabia to aid in determining whether outpatient management of such cases is appropriate.
 Methods: We conducted a retrospective chart review of febrile children less than 14 years of age admitted with sickle cell disease 2005 through 2015.
 Results: During 320 admissions, 25 children had SBIs (8%) including pneumonia (n=11), osteomyelitis (n=8), bacteremia (n=3, all with Salmonella species) and UTI (n=3). All recovered uneventfully.
 Conclusion: It appears that in the current era, less than 10% of febrile children with sickle cell disease in our center are diagnosed with a SBI. Over an 11-year period, there were no sequelae or deaths from SBI. Given these excellent outcomes, outpatient ceftriaxone should be considered for febrile well appearing children with sickle cell disease if they have no apparent source and parents are judged to be reliable.

Bacteraemia Among Patients with Sickle Cell Disease in Nigeria: Association with Spleen Size and Function

“…Salmonella bacteremia is common among younger patients with SCD, with a peak incidence between 2 and 10 years, and can be associated with an increased risk of osteomyelitis. 19 , 10 In the current study, Salmonella sp was isolated in two of the children less than five years old, one of whom had a previous history and management for osteomyelitis of both femurs. The expanded bone marrow in patients with SCD, with its sluggish blood flow, is vulnerable to thrombosis, infarction, and fibrosis; this can result in ischemic foci, allowing for salmonellae localization.…”

Bacteremia in Subjects with Sickle Cell Disease: High Rate of Gram-Negative Isolates in the West African Context

“…Similar results by Alsaif in the vaccine era between 2005 and 2015 showed an important reduction in severe episodes of infection, affecting less than 10% of the febrile sickle cell population. On the other hand, none of these infections was related to Streptococcus pneumoniae [29]. For some authors, this could be the result of almost systematic prophylaxis against infections with penicillin and vaccination results in sickle cell disease subjects.…”