Autor(es):
Gaschignard, J ; Koehl, B ; Rees, DC ; Rincón-López, E ; Vanderfaeillie, A ; Pascault, A ; Allali, S ; Cela, E ; Odièvre, MH ; Hau, I ; Oliveira, M ; Guillaumat, C ; Brousse, V ; de Montalembert, M ; Navarro Gómez, ML ; Beldjoudi, N ; Bardon-Cancho, EJ ; Epalza, C ; Benkerrou, M ; Gaschignard, J ; Koehl, B ; Pascault, A ; Brousse, V ; Allali, S ; de Montalembert, M ; Odièvre, MH ; Hau, I ; Guillaumat, C ; Blais, S ; Runel-Belliard, C ; Pellegrino, B ; Malric, A ; Guitton, C ; Gouraud, F ; Petras, M ; Bensaid, P ; Basmaci, R ; Eyssette-Guereau, S ; Pham, LL ; Bardon-Cancho, EJ ; Cela, E ; Gómez, ML ; Rincon-Lopez, E ; Ruiz-Llobet, A ; Adan, R ; Puyo, PV ; Recasens, V ; Epalza, C ; Perez-Alonso, V ; Torrent, M ; Gomez, AB ; Vázquez, A ; Rodríguez, RP ; Alfaridi, H ; Almaghrabi, R ; Hoyoux, M ; Vanderfaeillie, A ; Ferreira, T ; Rees, D
Data: 2023
Identificador Persistente: http://hdl.handle.net/10400.17/4817
Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
Assunto(s): Sickle Cell Disease; Invasive Bacterial Infections; Child; HDE HEM PED
Descrição
Background: Children with sickle cell disease (SCD) are at a high risk of invasive bacterial infections (IBI). Universal penicillin prophylaxis and vaccination, especially against Streptococcus pneumoniae, have deeply changed its epidemiology. Analysis of IBI in children with SCD in a post-13-valent pneumococcal vaccine era is limited. Methods: Twenty-eight pediatric hospitals from 5 European countries retrospectively collected IBI episodes in SCD children aged 1 month to 18 years between 2014 and 2019. IBI was defined as a positive bacterial culture or polymerase chain reaction from a normally sterile fluid: blood, cerebrospinal, joint, or pleural fluid and deep surgical specimen. Results: We recorded 169 IBI episodes. Salmonella spp. was the main isolated bacteria (n = 44, 26%), followed by Streptococcus pneumonia (Sp; n = 31, 18%) and Staphylococcus aureus (n = 20, 12%). Salmonella prevailed in osteoarticular infections and in primary bacteremia (45% and 23% of episodes, respectively) and Sp in meningitis and acute chest syndrome (88% and 50%, respectively). All Sp IBI occurred in children ≤10 years old, including 35% in children 5 to 10 years old. Twenty-seven (17%) children had complications of infection and 3 died: 2 because of Sp, and 1 because of Salmonella. The main risk factors for a severe IBI were a previous IBI and pneumococcal infection (17 Sp/51 cases). Conclusions: In a post-13-valent pneumococcal vaccine era, Salmonella was the leading cause of bacteremia in IBI in children with SCD in Europe. Sp came second, was isolated in children ≤10 years old, and was more likely to cause severe and fatal cases.
