Related Experiment Video
Updated: Mar 1, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Invasive Pneumococcal Disease in Patients With Sickle Cell Disease
Pournima Navalkele1, Bülent Özgönenel, Eric McGrath
1*The Carman and Ann Adams Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit †Pediatric Hematology and Oncology §Pediatric Infectious Diseases, Detroit ∥Department of Microbiology, Detroit Medical Center University Laboratories, Detroit, MI ‡Department of Pediatrics, Saint Louis University, Cardinal Glennon Children's Hospital, Saint Louis, MO.
Insights
Patients with sickle cell disease (SCD) face high risks of invasive pneumococcal disease (IPD). Breakthrough infections, often from non-vaccine strains, occur after age five when penicillin prophylaxis stops.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Patients with sickle cell disease (SCD) have an increased risk of fatal sepsis from encapsulated bacteria like Streptococcus pneumoniae due to autosplenectomy.
- While penicillin prophylaxis and pneumococcal vaccination reduce this risk, invasive pneumococcal disease (IPD) rates remain high in SCD patients compared to the general population.
Purpose of the Study:
- To analyze the characteristics and outcomes of invasive pneumococcal disease (IPD) in pediatric patients with sickle cell disease (SCD).
- To identify risk factors and serotypes involved in IPD among children with SCD.
Main Methods:
- A retrospective analysis of microbiology records was conducted for patients with SCD who developed IPD between 2004 and 2013.
- Data collected included risk factors, SCD type, vaccination and prophylaxis status, clinical presentation, microbiological data, and IPD outcomes.
Main Results:
- Eight pediatric patients with SCD developed IPD, primarily bacteremia.
- Serotype analysis of three isolates revealed non-vaccine serotypes (15C and 15A), with one fatal outcome associated with serotype 15A.
Conclusions:
- Breakthrough IPD cases in SCD patients can be caused by non-vaccine serotypes.
- These infections appear more common after age five, coinciding with the termination of oral penicillin prophylaxis.
Background:
Patients with sickle cell disease (SCD) are at risk of fatal sepsis with encapsulated bacteria, such as Streptococcus pneumoniae, because of the inherent autosplenectomy that occurs in SCD. This risk is thwarted with oral penicillin prophylaxis during the first 5 years of life, and with stringent vaccination against S. pneumoniae alongside routine childhood immunization. But compared with the general African American pediatric population, the rate of invasive pneumococcal disease (IPD) in patients with SCD still remains high, resulting in hospitalization and fatality.
Methods:
Patients with SCD who developed IPD from 2004 up to 2013 were identified using microbiology records. Descriptive analysis of presence of risk factors for IPD, type of SCD, pneumococcal vaccination and prophylaxis status, clinical presentation, microbiological data, and the outcome of IPD was performed.
Results:
Eight patients with SCD developed IPD (7 bacteremia and 1 respiratory tract infection). Three of the 8 isolates underwent serotype analysis (15 C in 2 and 15A in 1), none covered with the current vaccination program. One patient had fatal outcome (15A).
Conclusions:
Breakthrough cases of IPD may involve nonvaccine isolates, and seem to occur after 5 years of age when oral penicillin prophylaxis has been terminated.
More Related Videos
07:24A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
12:21A Mouse Model for the Transition of Streptococcus pneumoniae from Colonizer to Pathogen upon Viral Co-Infection Recapitulates Age-Exacerbated Illness
Published on: September 28, 2022
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:29Pneumonia II: Pathophysiology
01:29Endocarditis IV: Nursing Management