Prevalence and pattern of bacterial isolate in febrile children with sickle cell anemia in a tertiary hospital in Northern Nigeria

Abstract

Context: Bacterial infections constitute a major cause of morbidity and mortality in children with sickle cell anemia (SCA). These children have increased susceptibility to bacterial infections, the pattern of which varies with place and time. Knowledge of local pattern of bacterial infection in SCA will facilitate empirical management. Aims: This article aims to determine the prevalence and pattern of bacterial isolates and their in vitro antibiotic sensitivities in febrile children with SCA. Settings and Design: A comparative cross-sectional study was conducted at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods and Material: Two hundred and thirty-two febrile children with SCA between 6 months and 15 years and another 232 febrile children with AA phenotype were investigated for bacterial infections. Blood and urine cultures were done in all the patients and other cultures were performed based on the patients’ clinical presentation. Statistical Analysis Used: Data was analyzed using Epi Info statistical software. Results: Bacterial cultures were positive in 34 (14.7%) of children with SCA and 40 (17.2%) of the controls. The three most frequently isolated pathogens among both children with and without SCA were Staphylococcus aureus (23.5%; 25.0%), Escherichia coli (23.5%; 20.0%), and Klebsiella spp. (14.7%; 17.5%). Bacterial infection was significantly more common in children less than 5 years with SCA (χ2 = 3.98, df = 1, P = 0.046). Most of the organisms isolated were sensitive to third-generation cephalosporins. Conclusions: Gram-negative bacteria were the most common isolates in febrile children with SCA. Boys less than 5 years have higher positivity rates. In children with SCA admitted with suspected bacterial infection, third-generation cephalosporins should be the antibiotic of choice for empirical treatment.