Polysaccharide encapsulated bacterial infection in sickle cell anemia: A thirty year epidemiologic experience

  title={Polysaccharide encapsulated bacterial infection in sickle cell anemia: A thirty year epidemiologic experience},
  author={Wing-yen Wong and Darleen R. Powars and Linda S. Chan and Alan L. Hiti and Cage S. Johnson and Gary D. Overturf},
  journal={American Journal of Hematology},
Annual age‐specific incidence rates of Streptococcus pneumoniae or Haemophilus influenzae bacterial septicemia in sickle cell anemia (SS) were determined for the years of 1957 through 1989. Forty‐nine patients had 64 episodes of septicemia among a population of 786 SS patients observed for 8,138 person‐years. Peak frequency of infection occurred between 1968‐1971 and 1975‐1981 with a conspicuous absence of episodes in 1972, 1973, 1982‐1984, and 1986‐1987, thus demonstrating cycles of high and… 
Invasive pneumococcal disease in homozygous sickle cell disease: Jamaican experience 1973-1997.
Pneumococcal immunization appears to ameliorate the course of invasive disease andPenicillin remains the mainstay of prophylaxis, although breakthroughs occur and will become more common with the increasing frequency of penicillin-resistant organisms.
Streptococcus pneumoniae Sepsis and Meningitis During the Penicillin Prophylaxis Era in Children With Sickle Cell Disease
The observed severe pneumococcal infection rate in SS children younger than 5 years was less than that reported before penicillin prophylaxis, supporting routine peniillin pro phylaxis in this specific population of children with sickle cell disease.
Antibiotic‐Resistant Pneumococcal Infection in Children with Sickle Cell Disease in the United States
The increasing prevalence of antibiotic-resistant Streptococcus pneumoniae infection in the United States poses special problems for patients with sickle cell disease, and Prompt antibiotic susceptibility testing of pneumococcal isolates should be performed.
Invasive bacterial infections in Gambians with sickle cell anemia in an era of widespread pneumococcal and hemophilus influenzae type b vaccination
The low prevalence of S pneumoniae and Hib and the predominance of nontyphoidal Salmonella as a cause of bacteremia suggest the need to reconsider optimal antimicrobial prophylaxis and the empirical treatment regimens for patients with SCA.
Prevention and Management of Infection in Children with Sickle Cell Anaemia
  • W. Wong
  • Medicine, Biology
    Paediatric drugs
  • 2001
Penicillin prophylaxis has decreased the incidence of infection-related morbidity and mortality significantly in children with sickle cell anaemia, and the administration of various childhood vaccines has made an appreciable impact on the overall morbidities and mortality associated with infection.
Clinical events in the first decade in a cohort of infants with sickle cell disease. Cooperative Study of Sickle Cell Disease.
Within the Cooperative Study of Sickle Cell Disease, 694 infants with confirmed sickle cell disease were enrolled at less than 6 months of age. Information about the nature and frequency of
Bloodstream infections in hospitalized adults with sickle cell disease: A retrospective analysis
Empiric therapy for adults with SCD suspected of having BSI, especially in the presence of indwelling central venous catheters, should include antimicrobial therapy targeted at gram‐positive bacteria (especially MRSA) and gram‐negative bacteria.
Outcome of Sickle Cell Anemia: A 4-Decade Observational Study of 1056 Patients
The need for preventive therapy to ameliorate the progression of the sickle vasculopathy is underscored, and the influence of calendar era, age, sex, and prior medical conditions on the subsequent development of irreversible organ damage and survival is investigated.
Fever in an Adult with Sickle Cell Disease: To Treat or Not to Treat? A Case of Multi-Organ Failure
It is strongly recommend that all fever in adults with sickle cell disease be treated as a medical emergency and receive empiric antibiotic therapy in addition to routine work-up and investigations.
Septic complications after splenectomy for sickle cell sequestration crisis
There was no increase in infections or episodes of sepsis in SCD patients who underwent splenectomy, although infections are common in children with SCD, and there were no operative deaths.


Pneumococcal septicemia in children with sickle cell anemia. Changing trend of survival.
A decrease in major morbidity is attributed to the establishment of a clinical program that provides close medical supervision of the SS child with fever and the rapid institution of parenteral antibiotic therapy.
Bacteremia in sickle hemoglobinopathies.
Bacterial meningitis and septicemia in sickle cell disease.
After the first decade, illnesses among patients with all types of sickle cell disorders were frequently associated with an identifiable source of infection, a chronic course, and frequent involvement of Gram-negative organisms.
Mortality in children and adolescents with sickle cell disease. Cooperative Study of Sickle Cell Disease.
Comparison of this study's overall mortality with previous reports indicates improvement of survival in US patients less than 20 years of age with sickle hemoglobinopathies, and this improvement is most likely due to parental education and counseling about the illness and the early institution of antibiotics in suspected infections.
Prophylaxis with oral penicillin in children with sickle cell anemia. A randomized trial.
It is concluded that children should be screened in the neonatal period for Sickle cell hemoglobinopathy and that those with sickle cell anemia should receive prophylactic therapy with oral penicillin by four months of age to decrease the morbidity and mortality associated with pneumococcal septicemia.
Epidemiologic studies of Streptococcus pneumoniae in infants: acquisition, carriage, and infection during the first 24 months of life.
A natural history study of pneumococcal infection in 82 infants followed from birth is reported, finding infection usually occurred within one month of acquisition of a new type and was seldom associated with prolonged carriage.
Diplococcus pneumoniae infections in children with sickle cell anemia.
In the last 4⅓ years, 12 episodes of Diplococcus pneumoniae bacteremia or meningitis, or both, were observed in ten children with sickle cell anemia, and two patients died in spite of appropriate therapy.
Fulminant pneumococcemia and sickle cell anemia.
The data support the previously reported association of single or recurrent attacks of nonfulminant pneumococcal meningitis with hemoglobin SS disease and the proposal that sickle cell hemoglobinopathies are host factors, similar to the postsplenectomy state, that predispose the patient to fulminant pneumonia.
Spread of Streptococcus pneumoniae in families. II. Relation of transfer of S. pneumoniae to incidence of colds and serum antibody.
Preexisting, type-specific serum antibody did not prevent acquisition of homotypic S. pneumoniae but did appear to shorten the duration of pharyngeal carriage, which was associated with illness in six of the children.
Pneumococcal Meningitis in Sickle-Cell Anemia.
In a recent survey of 305 patients with sickle-cell anemia, hemoglobin C-S and hemoglobin-S-thalassemia disease, it is noted that in 87 per cent of patients with proved bacterial meningitis and Sickle- cell anemic, the pneumococcus is the responsible organism even in an age group when it is not the most common etiologic agent.