Antibiotic-resistant pneumococcal infection in children with sickle cell disease in the United States

Winfred C. Wang, Wing Yen Wong, Zora R. Rogers, Judith A. Wilimas, George R. Buchanan, Darleen R. Powars

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objective: The purpose of this report is to examine the increasing problem of antibiotic-resistant pneumococcal infection in children with sickle cell disease in the United States. Patients and Methods: In this retrospective review, 16 children with sickle cell disease and penicillin-resistant pneumococcal invasive infection were identified. They had a median age of 2 years (range 1-15) and were treated in Memphis, Dallas, Los Angeles, and five other cities between 1987 and early 1995. Results: At presentation, patients frequently had high fever (≥ 40.0 °C in 75%) and a toxic appearance (44%). Meningitis was present initially in two and diagnosed on days 4 and 5 in two. All were treated with an intravenous cephalosporin and nine received vancomycin. The clinical course was variable: two died within 36 h of presentation. In 20-86% of cases the organisms were resistant to cephalosporins, chloramphenicol, trimethoprim/sulfamethoxazole, erythromycin, and clindamycin; none were resistant to vancomycin. Conclusions: (a) The increasing prevalence of antibiotic-resistant Streptococcus pneumoniae infection in the United States poses special problems for patients with sickle cell disease. (b) Prompt antibiotic susceptibility testing of pneumococcal isolates should be performed. (c) Initial antibiotic management for patients suspected of sepsis/meningitis should include intravenous cephalosporin and vancomycin. (d) No alternative to penicillin prophylaxis is currently available. (e) An effective conjugated pneumococcal vaccine is needed.

Original languageEnglish (US)
Pages (from-to)140-144
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume18
Issue number2
DOIs
StatePublished - May 22 1996

Keywords

  • Streptococcus pneumoniae
  • antibiotic-resistant infection
  • meningitis
  • penicillin-resistant infection
  • sepsis
  • sickle cell disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Fingerprint Dive into the research topics of 'Antibiotic-resistant pneumococcal infection in children with sickle cell disease in the United States'. Together they form a unique fingerprint.

  • Cite this