INFECTIONS ET PROPHYLAXIES ANTIINFECTIEUSES DANS LA DRÉPANOCYTOSE

Bacterial infections remain a major cause of morbidity and mortality among young children with sickle cell susceptibility to infections is mainly observed in homozygous sickle cell disease. The incidence of bacteremias in children under 3 years of age is ~8 events/100 patient-years among
homozygous subjects and ~5 events/100 patient-years among those with SC hemoglobinopathy. Pneumococci and Salmonellae are the most frequently isolated bacteria. Severe clinical
manifestations include septicemia, meningitis, osteomyelitis and pneumonia. M. Pneumoniae and C. Pneumoniae infections may be severe and may induce acute chest syndrome. The high incidence and severity of bacterial infections in these children justify prevention efforts by antibiotic prophylaxis and vaccination. The efficacy of oral penicillin prophylaxis against pneumococcal infections has been well demonstrated and is now recommended from 3 months of age. The antipneumococcal conjugate vaccine has been shown to be safe and immunogenic in young infants.