Variation in the pattern of bacterial infection in patients with sickle cell disease requiring admission.

In order to determine the prevalence and pattern of bacterial infections in children with sickle cell disease (SCD) admitted with acute illness, a prospective study of 304 sicklers aged 3 months to 15 years was carried out over 1 year in the emergency pediatric unit of ABU Teaching Hospital Kaduma. Initial blood and urine cultures were obtained in all cases and other cultures were performed as determined by the patients' clinical condition. Almost 60 per cent of the patients had positive bacterial cultures with gram negative organisms accounting for 55 per cent of them, but the single most predominant organism isolated was Staphylococcus aureus. Of note was the strikingly low isolation rate of Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitides. Possible reasons for this difference from the majority of reports from the western World are advanced and the implications discussed, especially as regards vaccination programmes in sickle cell disease and initial antibiotic treatment of those with acute illness.