Frequency and Patterns of Bacteraemia in Children with Sickle Cell Disease: A Prospective Cohort Study

Abstract

Introduction: Sickle Cell Disease (SCD) is one of the most common inherited haemoglobinopathies and is associated with high morbidity and mortality, particularly in early childhood among the affected population. Infection is a significant contributor to morbidity and mortality in SCD. Aim: To investigate the frequency and pattern of bacteraemia in children with SCD. Materials and Methods: This prospective cohort study was conducted in the Department of Paediatricss at Acharya Vinoba Bhave Hospital, Sawangi (M), Wardha, Maharashtra, India, a tertiary care hospital attached to Jawaharlal Nehru Medical College from October 2019 to September 2021. A total of 70 patients with SCD, aged upto 18 years, who presented with fever on two separate occasions and were admitted to the hospital, were included in the study. Blood culture, complete blood counts, and C-reactive Protein (CRP) tests were conducted to detect bacteraemia immediately after admission and when required. Quantitative data was analysed using mean, median, and standard deviation. Results: In the present study, out of 70 patients, 40 (57.14%) were male and 30 (42.86%) were female. A total of 54 (77.14%) were homozygous and 16 (22.86%) were heterozygous for SCD. A total of 30 (42.86%) patients belonged to the 6-10 years age group. Fever and pallor were the most common clinical findings. The rate of bacteraemia was found to be 15.71%. Gramnegative organisms were more frequently isolated compared to gram-positive isolates. The most common organism isolated in sickle cell patients was Klebsiella species (36.36%). Conclusion: Bacteraemia was observed in only approximately 15.71% of the patients. Gram-negative bacteraemia was more prevalent in patients with SCD. Patients with acute chest syndrome were more susceptible to bacterial infections. Mortality was higher in sickle cell patients from whom organisms were isolated in blood cultures.