Predictors for bacteremia in febrile sickle cell disease children in the post-7-valent pneumococcal conjugate vaccine era

Todd P. Chang, Worapant Kriengsoontorkij, Linda S. Chan, Vincent J. Wang

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objectives: The objective of this study was to determine the incidence of bacteremia in febrile sickle cell disease (SCD) children before and after the 7-valent pneumococcal vaccine (PCV7), and to determine clinical factors associated with bacteremia following PCV7. Patients and Methods: We reviewed all febrile events in SCD children from 1993 to 2009 at a tertiary care pediatric center, comparing general bacteremia and pneumococcal bacteremia incidence for 3 time periods around the PCV7. Univariate analysis and stepwise logistic regression identified clinical factors most associated with bacteremia in this population. Results: Of 466 SCD children identified, there were 2504 febrile events. We found 84 cases of bacteremia; 8 were pneumococcal. The general bacteremia incidence decreased significantly from 5.60% to 2.44% (P<0.001) over time. Pneumococcal bacteremia incidence did not decrease (P=0.13). Following PCV7, we identified 4 significant independent risk factors associated with general bacteremia: the presence of a central venous line, higher absolute band count, toxic appearance, and older age. Conclusions: In febrile SCD children, the incidence of general bacteremia decreased over time. No decrease in pneumococcal bacteremia was found. The presence of a central venous line, absolute band count, clinical appearance, and age may help predict bacteremia in this population.

Original languageEnglish (US)
Pages (from-to)377-382
Number of pages6
JournalJournal of Pediatric Hematology/Oncology
Volume35
Issue number5
DOIs
StatePublished - Jul 1 2013

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Keywords

  • 7-valent PCV
  • Bacteremia
  • Invasive pneumococcal disease
  • Predictors
  • Prevnar
  • Risk factor
  • Sickle cell
  • Streptococcus pneumoniae
  • Vaccine

ASJC Scopus subject areas

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

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