Laboratory indices of hospitalized Sickle Cell Disease Patients, Prevalence and Antimicrobial Susceptibility of pathogenic bacterial isolates at MRCG Ward in the Gambia

Abstract

Abstract Background: The aim of this study was to determine the prevalence of invasive bacterial infections and their antimicrobial susceptibility patterns in sickle cell disease (SCD) patients admitted at the Medical Research Council the Gambia (MRCG) Ward in the era of PCV and Hib vaccination in the Gambia. Methods and Results: This study was conducted in the clinical laboratory department of MRCG. We retrospectively generated haematological, and blood culture data from our electronic medical records from 2015 to 2022 of SCD patients admitted to MRCG Ward. Of 380 sickle cell disease patients, blood culture was requested only for 159. Of the 159 admitted SCD, 11 (6.9%) patients had qualified positive blood cultures. Five different types of pathogens were isolated from these positive blood cultures: 4 Staphylococcus aureus(36.4 %), 3 Streptococcus pneumoniae(27.2%), 2 Salmonella species(18.2%), 1 Enterococcus species(9%), and 1 Shigella boydii(9%). No episode of bacteremia caused by Haemophilus influenzae type b was identified and one patient was serologed as positive for hepatitis B. The molecular serotyping of the Streptococcus pneumoniae isolates revealed non-vaccine serotypes 10A, 12F and 12F. Penicillin resistance was recorded in two of the three Streptococcus pneumoniae and all the Staphylococcus aureus pathogens isolated in blood cultures. However, all isolated pathogens were sensitive to chloramphenicol, cloxacillin and vancomycin. Conclusion: Streptococcus pneumoniae and Staphylococcus aureus were the most common cause of bacteremia in these admitted SCD patients. Penicillin resistance should be considered during penicillin prophylaxis and empirical treatment regimens for SCD patients and future SCD management policies in the Gambia.