Bacterial blood cultures in children with sickle cell disease

Background: Children with sickle cell disease (SCD) are considered at risk for bacteremia, especially when they present to the emergency department (ED) with lever. Objective: We aimed to determine the incidence of bacteremia in children with SCD presenting with or without fever to a pediatric ED. Methods: A retrospective chart review of 692 pediatric ED visits of children with SCD during a 2-year period was conducted. Results: Seven blood cultures (6 homozygous and 1 heterozygous) had bacterial growth (1.3%; 95% confidence interval, 0.5-2.1), 3 of which were among febrile children (1.7%; 95% confidence interval, 0-3.6). All identified microorganisms are part of the normal skin or oral flora and could represent contamination. None of the patients had growth of the Streptococcus pneumoniae species. Conclusion: A very low rate of bacterial growth and no S pneumoniae were found. The absence of S pneumoniae in our cohort can be associated with the addition of the 7-valent pneumococcal conjugate vaccine. (C) 2010 Elsevier Inc. All rights reserved.