Incidence and predictors of bacterial infections in febrile children with sickle cell disease

Abstract

Introduction

Sickle cell disease (SCD) is an autosomal recessive disorder. The incidence of bacterial infection in children with SCD globally is 16% compared 3–14% in general children. Bacterial infection in children is a severe problem and is considered to be a life-threatening condition. To reduce antibiotic overuse, the following factors might be associated with bacterial infection could help: age, C-reactive protein (CRP), white blood cells (WBCs) count, absolute neutrophil count (ANC), and genotype. Therefore, this study is designed to evaluate the CRP, ANC, WBCs, and platelet count levels as predictors for bacterial infection in febrile children with sickle cell anemia over a six-year period in a tertiary center in Jeddah, Saudi Arabia.

Methods

This study was a retrospective record review that included all SCD patients below the age of 18 years who presented with a febrile episode at any hospital’s department from 2017 to 2019. Data were extracted from patient files that included culture result and the causative organism, CRP level, WBCs, ANC, and platelet count.

Results

The study included 62 children diagnosed with SCD who presented with 89 febrile episodes. There was no statistically significant difference in the median of CRP and ANC between the bacterial and nonbacterial febrile episodes (P = .314, .735, respectively). However, the level of WBC> 20 K/μL was statistically significant at P = .025.

Conclusion

WBCs significantly associated with a bacterial infection in SCD febrile children along with clinical assessments. This parameter can guide the physicians to determine the children at high risk of bacterial infection.