Infections in sickle cell disease

Background: Infections are the most frequent complications in individuals with sickle cell disease. Infection is a significant contributor to morbidity and mortality in sickle cell disease. Materials and methods: A prospective study was carried out in a total of 100 patients to study prevalence and type of infections in homozygous sickle cell disease patients in both sexes and all age groups at Department of Pathology of our institute. All homozygous (SS) sickle cell disease patients with high grade fever of temperature > 101˚F (38˚C) from all age groups and both sexes were included without administration of first antibiotic dose. The identification of the infecting organism was done by staining, and culture studies. Results: The results were analyzed using standard microbiological techniques. In present study, maximum cases were seen in 0-5 years of age group, the cases of infection were more in males (62%) than in females (38%) with M: F ratio of 1.63:1. In the present study, respiratory tract infection was present in 37% cases. The positivity of blood culture was 27% (27 out of 100). Out of 27 blood culture positive cases, Gram negative organisms isolated were Klebsiella (51.55%), Escherichia coli (14.81%), Salmonella (7.40%), Acinetobacter (3.70%) and Gram positive isolates were Enterococcus ( 7.40%), Staphylococcus aureus (11.11%), Streptococcus Pneumoniae (3.70%). Therefore this study was conducted out to assess the patterns of morbidity and mortality due to infections in sickle cell disease and to implement various measures of preventive care and treatment in future. Conclusion: The incidence of infection was more common in age group 0-5 years. The incidence of infection was more common in males as compared to females. Respiratory tract infection was the most common infection. Gram negative organism - Klebsiella pneumoniae was the most common organism isolated followed by E. coli, Salmonella and Acinetobacter. Among Gram positive organism - staphylococcus aureus, enterococcus, Streptococcus pneumoniae were common bacterial isolates. Among non-bacterial causes - Malaria was common infection.