[en] 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.
Disciplines :
Pediatrics Immunology & infectious disease
Author, co-author :
Gaschignard, Jean; Department of Pediatrics, Groupe Hospitalier Nord Essonne, Longjumeau, France. ; IAME, INSERM 1137, Hôpital Bichat, Paris, France.
Koehl, Bérengère; Departments of Sickle Cell Disease, Hôpital Robert Debré. ; Université de Paris-Cité, Paris, France. ; INSERM U1134, Integrated Red Globule Biology, Paris, France.
Rees, David C; Red Cell Haematology Laboratory, School of Cancer and Pharmaceutical Sciences, King's College London and King's College Hospital, London, United Kingdom.
Rincón-López, Elena; Departments of Pediatrics. ; Biomedical Research Networking Center on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Vanderfaeillie, Anna; Department of Pediatrics, UMC Saint Pierre, Brussels, Belgium.
Pascault, Alice; Departments of Sickle Cell Disease, Hôpital Robert Debré.
Allali, Slimane; General Pediatrics and Pediatric Infectious Diseases, Sickle Cell Center, Necker-Enfants Malades Hospital, Université Paris Cité. ; Université de Paris-Cité, Paris, France.
Cela, Elena; Pediatric Hematology and Oncology Unit, Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Odièvre, Marie-Hélène; Pediatrics, Hôpital Trousseau. ; Université de Paris-Cité, Paris, France.
Hau, Isabelle; Department of Pediatrics, Centre Hospitalier Intercommunal, Créteil, France.
Oliveira, Marisa; Pediatric Hematology Unit, Hospital D. Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Guillaumat, Cécile; Department of Pediatrics, Centre Hospitalier Sud Francilien, Corbeil-Essonne, France.
Brousse, Valentine; Departments of Sickle Cell Disease, Hôpital Robert Debré. ; Université de Paris-Cité, Paris, France. ; INSERM U1134, Integrated Red Globule Biology, Paris, France.
de Montalembert, Mariane; General Pediatrics and Pediatric Infectious Diseases, Sickle Cell Center, Necker-Enfants Malades Hospital, Université Paris Cité. ; Université de Paris-Cité, Paris, France.
Navarro Gómez, Maria Luisa; Departments of Pediatrics. ; Biomedical Research Networking Center on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Beldjoudi, Naima; Epidemiology and Clinical Research Department, GH Paris Nord Val de Seine, Assistance Publique - Hôpitaux de Paris, Paris, France.
Bardon-Cancho, Eduardo Jesus; Pediatric Hematology and Oncology Unit, Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Epalza, Cristina; Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain. ; Paediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain. ; Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain.
Hoyoux, Marie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pédiatrie
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