Antibiotic-Resistant Pneumococcal Infection in Children with Sickle Cell Disease in the United States
- 1 May 1996
- journal article
- Published by Wolters Kluwer Health in Journal of Pediatric Hematology/Oncology
- Vol. 18 (2), 140-144
- https://doi.org/10.1097/00043426-199605000-00008
Abstract
Objective: The purpose of this report is to examine the increasing problem of antibiotic-resistant pneumocoecal 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/sul-famethoxazole. 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.Keywords
This publication has 9 references indexed in Scilit:
- Multi‐drug resistance to Streptococcus pneumoniae in sickle cell anemiaAmerican Journal of Hematology, 1995
- Management of Infections Caused by Antibiotic-Resistant Streptococcus PneumoniaeNew England Journal of Medicine, 1994
- ANTIBIOTIC-RESISTANT PNEUMOCOCCAL DISEASE AT ARKANSAS CHILDRENʼS HOSPITAL, 1990 TO 1993The Pediatric Infectious Disease Journal, 1994
- Dilemmas in diagnosis and management of cephalosporin-resistant Streptococcus pneumoniae meningitisThe Pediatric Infectious Disease Journal, 1993
- Infection Caused by Streptococcus pneumoniae in Children with Sickle Cell Disease: Epidemiology, Immunologic Mechanisms, Prophylaxis, and VaccinationClinical Infectious Diseases, 1992
- Polysaccharide encapsulated bacterial infection in sickle cell anemia: A thirty year epidemiologic experienceAmerican Journal of Hematology, 1992
- Characteristics and antibiotic therapy of adult meningitis due to penicillin-resistant pneumococciAmerican Journal Of Medicine, 1988
- Bacteremia in sickle hemoglobinopathiesThe Journal of Pediatrics, 1986
- Prophylaxis with Oral Penicillin in Children with Sickle Cell AnemiaNew England Journal of Medicine, 1986