Gbadoé Adama Dodji, Guédénon Koffi Mawuse, N'zonou Magnoulelen, Adamou Mahamadou, Akolly Djatougbé, Guédéhoussou Têtê, Dagnra Anoumou Yaotsé
Hemato-oncology Unit of the Pediatrics Department.
Pediatrics Department of the District Hospital of Be.
J Pediatr Hematol Oncol. 2023 Oct 1;45(7):404-408. doi: 10.1097/MPH.0000000000002710. Epub 2023 Jul 27.
Bacterial infections are considered a major cause of morbidity and mortality in patients, especially children, with sickle cell disease.
This study aims at determining, a year after the introduction of the 13-valent pneumococcal conjugate vaccine the distribution of severe acute bacterial infections and germs in children with sickle cell disease.
Records of children 0 to 15 years of age and admitted from January 1, 2015 to December 31, 2019 (5 y), were examined retrospectively in the four sickle cell monitoring units in Lomé.
The main infections found were pleuropulmonary (46.1%), urinary tract (32.8%), and osteoarticular (9.3%). A germ was isolated in 139 of the 265 cases (52.4%). 65.5% of the microorganisms isolated were Gram-negative organisms, with mostly Escherichia coli (31.6%) , and Klebsiella pneumoniae (18%) being the main germs. They were mainly responsible of urinary tract and osteoarticular infections. The majority of these Enterobacteriaceae was Extended-Spectrum Beta-Lactamase-Producing (41.1%, n = 37). Gram-positive cocci were represented by Staphylococcus sp (25.9%), Streptococcus sp (4.3%), Streptococcus pneumoniae (2.9%), and Enterococcus (1.4%). Staphylococcus aureus was the most common germ in pleuropulmonary (40%), osteoarticular (47.3%), and sepsis (28.6%) infections.
Even if the infections found remained classic, there is a redistribution of germs with a decline in Salmonella and increase of Escherichia coli , Klebsiella pneumoniae , and Staphylococcus aureus .
细菌感染被认为是镰状细胞病患者（尤其是儿童）发病和死亡的主要原因。
本研究旨在确定13价肺炎球菌结合疫苗引入一年后，镰状细胞病患儿严重急性细菌感染和病菌的分布情况。
回顾性检查2015年1月1日至2019年12月31日（5年）期间在洛美四个镰状细胞监测单位收治的0至15岁儿童的记录。
发现的主要感染为胸膜肺部感染（46.1%）、尿路感染（32.8%）和骨关节炎感染（9.3%）。265例病例中有139例（52.4%）分离出病菌。分离出的微生物中有65.5%为革兰氏阴性菌，其中主要是大肠杆菌（31.6%）和肺炎克雷伯菌（18%）。它们主要导致尿路感染和骨关节炎感染。这些肠杆菌科细菌大多数产超广谱β-内酰胺酶（41.1%，n = 37）。革兰氏阳性球菌包括葡萄球菌属（25.9%）、链球菌属（4.3%）、肺炎链球菌（2.9%）和肠球菌（1.4%）。金黄色葡萄球菌是胸膜肺部感染（40%）、骨关节炎感染（47.3%）和败血症感染（28.6%）中最常见的病菌。
即使发现的感染仍为常见类型，但病菌出现了重新分布，沙门氏菌减少，而大肠杆菌、肺炎克雷伯菌和金黄色葡萄球菌增多。
