Bacterial blood cultures in children with sickle cell disease

BackgroundChildren with sickle cell disease (SCD) are considered at risk for bacteremia, especially when they present to the emergency department (ED) with fever.ObjectiveWe aimed to determine the incidence of bacteremia in children with SCD presenting with or without fever to a pediatric ED.MethodsA retrospective chart review of 692 pediatric ED visits of children with SCD during a 2-year period was conducted.ResultsSeven 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.ConclusionA 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.