Deena Savlov1, Carolyn E Beck, Julie DeGroot, Isaac Odame, Jeremy N Friedman. 1. *Department of Paediatrics, Division of Paediatric Medicine ‡Department of Paediatrics, Division of Hematology/Oncology, The Hospital for Sick Children †Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Abstract
INTRODUCTION: Bacterial sepsis is more common and potentially life threatening in children with sickle cell disease (SCD). Identification of variables that predict bacteremia may aid clinicians in recognizing patients with SCD at higher risk for sepsis. OBJECTIVE: To determine whether absolute neutrophil count (ANC) >20×10/L is an independent risk factor for bacteremia in children with SCD and to identify other predictors of bacteremia in this population. METHODS: A case-control study was conducted. Subjects were 0 to 18 years of age admitted to a tertiary care pediatric hospital over a 17-year period with SCD and fever at presentation. Cases had bacteremia, whereas controls had negative blood cultures. RESULTS: Data were analyzed for 40 cases and 120 controls. ANC>20×10/L was significantly more prevalent among cases (odds ratio [OR], 7.0; 95% confidence interval [CI], 2.6-18.9). Cases were more likely to have emesis (OR, 2.9; 95% CI, 1.0-8.4) and a higher proportion of band cells (OR, 1.3; 95% CI, 1.1-1.4) at presentation. CONCLUSIONS: In a febrile child with SCD, an ANC>20×10/L, a higher proportion of band cells, and the presence of vomiting were associated with an increased likelihood of bacteremia.
INTRODUCTION: Bacterial sepsis is more common and potentially life threatening in children with sickle cell disease (SCD). Identification of variables that predict bacteremia may aid clinicians in recognizing patients with SCD at higher risk for sepsis. OBJECTIVE: To determine whether absolute neutrophil count (ANC) >20×10/L is an independent risk factor for bacteremia in children with SCD and to identify other predictors of bacteremia in this population. METHODS: A case-control study was conducted. Subjects were 0 to 18 years of age admitted to a tertiary care pediatric hospital over a 17-year period with SCD and fever at presentation. Cases had bacteremia, whereas controls had negative blood cultures. RESULTS: Data were analyzed for 40 cases and 120 controls. ANC>20×10/L was significantly more prevalent among cases (odds ratio [OR], 7.0; 95% confidence interval [CI], 2.6-18.9). Cases were more likely to have emesis (OR, 2.9; 95% CI, 1.0-8.4) and a higher proportion of band cells (OR, 1.3; 95% CI, 1.1-1.4) at presentation. CONCLUSIONS: In a febrile child with SCD, an ANC>20×10/L, a higher proportion of band cells, and the presence of vomiting were associated with an increased likelihood of bacteremia.
Authors: J Seni; A A Mwakyoma; F Mashuda; R Marando; M Ahmed; R DeVinney; J D D Pitout; S E Mshana Journal: BMC Pediatr Date: 2019-01-26 Impact factor: 2.125
Authors: Elena María Rincón-López; María Luisa Navarro Gómez; Teresa Hernández-Sampelayo Matos; David Aguilera-Alonso; Eva Dueñas Moreno; Jesús Saavedra-Lozano; Begoña Santiago García; María Del Mar Santos Sebastián; Marina García Morín; Cristina Beléndez Bieler; Jorge Lorente Romero; Elena Cela de Julián Journal: BMC Infect Dis Date: 2021-08-03 Impact factor: 3.090