Incidence and Predictors of Bacterial infection in Febrile Children with Sickle Cell Disease

Incidence and Predictors of Bacterial infection in Febrile Children with Sickle Cell Disease

Children with sickle cell disease are at increased risk of developing bacteremia and other serious bacterial infections. Fever is a common symptom in sickle cell disease and can also occur with sickle cell crises and viral infections. We aimed to evaluate the incidence and predictors of bacteremia a...

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Bibliographic Details
Published in:Hemoglobin Vol. 39; no. 5; pp. 316 - 319
Main Authors: Morrissey, Benita J., Bycroft, Thomas P., Almossawi, Ofran, Wilkey, Olufunke B., Daniels, Justin G.
Format: Journal Article
Language:English
Published: England Informa Healthcare 01-01-2015
Subjects:
Adolescent
Anemia, Sickle Cell - complications
Bacteremia
bacterial infections
Bacterial Infections - diagnosis
Bacterial Infections - epidemiology
Bacterial Infections - etiology
C-Reactive Protein
Child
Child, Preschool
fever
Fever - diagnosis
Fever - epidemiology
Fever - etiology
Hospitalization
Humans
Incidence
Infant
Leukocyte Count
London - epidemiology
Male
pediatrics
Prognosis
Retrospective Studies
sickle cell anemia
London
fever
bacterial infections
Bacteremia
pediatrics
sickle cell anemia
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Summary:Children with sickle cell disease are at increased risk of developing bacteremia and other serious bacterial infections. Fever is a common symptom in sickle cell disease and can also occur with sickle cell crises and viral infections. We aimed to evaluate the incidence and predictors of bacteremia and bacterial infection in children with sickle cell disease presenting with fever to a district hospital and sickle cell center in London. A retrospective analysis was performed on all attendances of children (aged under 16 years) with sickle cell disease presenting with a fever of 38.5 °C or higher over a 1-year period. Confirmed bacterial infection was defined as bacteremia, bacterial meningitis, urinary tract infection (UTI), pneumonia, osteomyelitis or other bacterial infection with positive identification of organism. Children were defined as having a suspected bacterial infection if a bacterial infection was suspected clinically, but no organism was identified. Over a 1-year period there were 88 episodes analyzed in 59 children. Bacteremia occurred in 3.4% of episodes and confirmed bacterial infection in 7.0%. Suspected bacterial infection occurred in 33.0%. One death occurred from Salmonella typhirium septicemia. C-reactive protein (CRP) level and white blood cell (WBC) count were both significantly associated with bacterial infection (p = 0.004 and 0.02, respectively.) In conclusion, bacterial infections continue to be a significant problem in children with sickle cell disease. C-reactive protein was significantly associated with bacterial infections, and could be included in clinical risk criteria for febrile children with sickle cell disease.
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ISSN:0363-0269
1532-432X
DOI:10.3109/03630269.2015.1065419