Abstract
Sickle cell disease (SCD) patients are thought to be at higher risk for urinary tract infections (UTIs) compared to the general population secondary to increased sickling, abnormal urinary acidification, and an inability to concentrate the urine. The incidence of UTI in febrile children with SCD in the United States is unknown. Our objectives were to determine the rate of UTI among febrile SCD children and describe the risk factors for UTI in this population. We conducted a retrospective chart review of all febrile SCD patients <4 years of age who presented to a pediatric emergency department from 2012–2017 and who had a sterile sample of urine for analysis. A total of 167 febrile patients with SCD with 464 visits were identified. The majority were African American (95.2%), female (58.7%), and had hemoglobin SS (HbSS) (65.3%). The rate of UTI was 4.1%. All patients with a UTI were African American females with a median age of 19 months (IQR 12–30). On regression analysis, no risk factors were associated with a UTI. We found the rate of UTI in febrile young children with SCD was comparable to non-SCD children. Larger studies are required to identify the presence of risk factors for UTI in this population.
Highlights
Sickle cell disease (SCD) is one of the most common genetic hematological diseases, with an estimated 100,000 Americans affected [1]
Our study showed that the rate of urinary tract infections (UTIs) in children
It has been reported that children with SCD are at greater risk for UTI compared with the general population [4]
Summary
Sickle cell disease (SCD) is one of the most common genetic hematological diseases, with an estimated 100,000 Americans affected [1]. Due to the subnormal immunity resulting from reduced or absent splenic function, children with SCD are at a higher risk for bacterial infections [2,3]. Patients with SCD have altered blood flow to the kidneys and low renal arterial oxygen tension. This causes increased sickling, abnormal urinary acidification, and an inability to concentrate the urine, resulting in an increased risk for urinary tract infections (UTIs) [3,4,5]. Studies exploring the pediatric rates of UTI in SCD with fever are limited, and results have ranged widely between 1–28% [4,6,7,8,9,10]
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