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Published on: February 23, 2014

Prevalence of pneumococcal bacteremia in children with sickle cell disease

Ami Patel1, Amra Zuzo, Hamayun Imran

  • 1University of South Alabama College of Medicine, Mobile, AL, USA.

Pediatric Hematology and Oncology
|April 11, 2013
PubMed

Insights

True bacteremia occurred in 4% of children with sickle cell disease hospitalized for fever. Pneumococcal bacteremia cases decreased significantly after the introduction of the 13-valent pneumococcal vaccine (PCV13).

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Sickle cell disease (SCD) increases susceptibility to infections.
  • Fever in children with SCD often necessitates hospitalization and evaluation for bacteremia.
  • The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in May 2010.

Purpose of the Study:

  • To determine the prevalence of true bacteremia in children with SCD hospitalized for fever.
  • To assess the impact of PCV13 introduction on pneumococcal bacteremia rates.
  • To analyze characteristics of patients with bacteremia.

Main Methods:

  • Retrospective chart review of 456 hospitalizations in 133 children with SCD from January 2006 to June 2012.
  • Analysis of blood cultures, patient demographics, and clinical data.
  • Comparison of bacteremia rates before and after PCV13 introduction.

Main Results:

  • The overall prevalence of true bacteremia was 4%.
  • Two cases of pneumococcal bacteremia (0.4%) were reported, both occurring before May 2010.
  • Patients with pneumococcal bacteremia had discontinued penicillin prophylaxis and had varying vaccination statuses.
  • Mean time to detection was significantly shorter for bacteremia (22.5 hours) versus contaminants (32.6 hours).

Conclusions:

  • True bacteremia is uncommon in children with SCD hospitalized for fever.
  • PCV13 introduction appears to have significantly reduced pneumococcal bacteremia in this population.
  • Discontinuation of penicillin prophylaxis and vaccination status are important considerations in managing febrile children with SCD.

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