Emergence of gram-negative organisms as the cause of infections in patients with sickle cell disease

Sara Khalife; Rima Hanna-Wakim; Rasha Ahmad; Rachid Haidar; Peter G Makhoul; Nabil Khoury; Ghassan Dbaibo; Miguel R Abboud

doi:10.1002/pbc.28784

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Emergence of gram-negative organisms as the cause of infections in patients with sickle cell disease

Journal article

Peer reviewed

Emergence of gram-negative organisms as the cause of infections in patients with sickle cell disease

Sara Khalife, Rima Hanna-Wakim, Rasha Ahmad, Rachid Haidar, Peter G Makhoul, Nabil Khoury, Ghassan Dbaibo and Miguel R Abboud

Pediatric blood & cancer, Vol.68(1), pp.e28784-n/a

01/2021

DOI: 10.1002/pbc.28784

PMID: 33128443

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Abstract

Patients with sickle cell disease are at higher risk of infections with encapsulated bacteria due to immature immune responses and functional asplenia. We aimed to study our patient population for the emergence of gram-negative organisms other than Salmonella as the cause of osteomyelitis and document a vast decrease in Streptococcus pneumoniae bacteremia rates. We conducted a retrospective chart review of 158 patients with sickle cell disease registered at our hospital. Over a period of 13 years, every patient presenting to the emergency department (ED) with fever had their medical record reviewed for blood cultures, wound cultures, and magnetic resonance imaging results for osteomyelitis. The number of patients presenting to the ED with fever was 105, with 581 febrile episodes and 893 blood cultures. Among those, no culture grew Streptococcus pneumoniae, 14 grew coagulase-negative staphylococci (1.5%), one grew Salmonella enterica Paratyphi B, and three grew Salmonella enterica group C (in the same patient). The total number of osteomyelitis episodes in patients with sickle cell disease presenting with fever and documented by imaging was nine (1.5%). In patients with osteomyelitis, organisms were isolated in four patients (44%), including Enterobacter cloacae, Bacteroides, Pseudomonas aeruginosa, and Salmonella enterica group C. Immunization against Streptococcus pneumoniae and the use of prophylactic penicillin has virtually eliminated pneumococcal bacteremia among our patients. We observed the emergence of gram-negative organisms other than Salmonella as the cause of osteomyelitis in patients with sickle cell disease.

Adolescent

Anemia, Sickle Cell - epidemiology

Anemia, Sickle Cell - pathology

Anemia, Sickle Cell - virology

Child

Child, Preschool

Female

Follow-Up Studies

Gram-Negative Bacteria - pathogenicity

Gram-Negative Bacterial Infections - complications

Gram-Negative Bacterial Infections - virology

Hospitalization - statistics & numerical data

Humans

Incidence

Infant

Infant, Newborn

Lebanon - epidemiology

Male

Osteomyelitis - epidemiology

Osteomyelitis - pathology

Osteomyelitis - virology

Prognosis

Retrospective Studies

Details

Title: Subtitle: Emergence of gram-negative organisms as the cause of infections in patients with sickle cell disease
Creators: Sara Khalife - American University of Beirut Medical Center
Rima Hanna-Wakim - American University of Beirut Medical Center
Rasha Ahmad - American University of Beirut Medical Center
Rachid Haidar - American University of Beirut Medical Center
Peter G Makhoul - American University of Beirut Medical Center
Nabil Khoury - American University of Beirut Medical Center
Ghassan Dbaibo - American University of Beirut Medical Center
Miguel R Abboud - American University of Beirut Medical Center
Resource Type: Journal article
Publication Details: Pediatric blood & cancer, Vol.68(1), pp.e28784-n/a
DOI: 10.1002/pbc.28784
PMID: 33128443
ISSN: 1545-5009
eISSN: 1545-5017
Language: English
Date published: 01/2021
Academic Unit: Radiology
Record Identifier: 9984697719402771

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5 Times Cited - Web of Science

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