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Bloodstream Infections in Children With Sickle Cell Disease: 2010-2019

Marianne E Yee1,2, Kristina W Lai1, Nitya Bakshi1,2

  • 1Aflac Cancer and Blood Disorders Center.

Pediatrics
|December 16, 2021
PubMed

Insights

Bloodstream infections (BSIs) remain a significant risk for children with sickle cell disease (SCD). Key pathogens include Streptococcus pneumoniae, with higher BSI odds in those with sickle cell anemia genotypes and chronic transfusions.

Area of Science:

  • Pediatric Infectious Diseases
  • Hematology
  • Epidemiology

Background:

  • Children with sickle cell disease (SCD) face a heightened risk of bloodstream infections (BSIs) due to functional asplenia.
  • While immunizations and antibiotic prophylaxis have decreased invasive bacterial infections, current data on BSIs in pediatric SCD patients are scarce.

Purpose of the Study:

  • To conduct a contemporary analysis of bloodstream infections (BSIs) in children with sickle cell disease (SCD).
  • To identify the incidence, common pathogens, and associated risk factors for BSIs in this vulnerable pediatric population.

Main Methods:

  • A retrospective cohort study analyzed blood cultures from children under 18 with SCD between 2010 and 2019.
  • Exclusion criteria included contaminant organisms and repeated cultures. Incidence rates and multivariate logistic regression were used to assess risk factors.

Main Results:

  • 156 BSI episodes occurred in 144 patients, with an average incidence rate of 0.89 per 100 person-years.
  • Common pathogens were Streptococcus pneumoniae, Streptococcus viridans group, Escherichia coli, Staphylococcus aureus, Bordetella holmesii, Haemophilus influenzae, and Salmonella species.
  • Sickle cell anemia genotypes (OR 1.88) and chronic transfusions (OR 2.66) increased BSI odds, while hydroxyurea (OR 0.57) decreased them.

Conclusions:

  • Bloodstream infections (BSIs) continue to pose a significant threat to children with sickle cell disease (SCD).
  • Understanding the current incidence, risk factors, and spectrum of pathogens is crucial for effective prevention and empirical treatment strategies in pediatric SCD patients.
Abstract

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