TY - JOUR
T1 - Invasive pneumococcal infections in children with sickle cell disease in the era of penicillin prophylaxis, antibiotic resistance, and 23-valent pneumococcal polysaccharide vaccination
AU - Adamkiewicz, Thomas V.
AU - Sarnaik, Sharada
AU - Buchanan, George R.
AU - Iyer, Rathi V.
AU - Miller, Scott T.
AU - Pegelow, Charles H.
AU - Rogers, Zora R.
AU - Vichinsky, Elliott
AU - Elliott, John
AU - Facklam, Richard R.
AU - O'Brien, Katherine L.
AU - Schwartz, Benjamin
AU - Van Beneden, Chris A.
AU - Cannon, Michael J.
AU - Eckman, James R.
AU - Keyserling, Harry
AU - Sullivan, Kevin
AU - Wong, Wing Yen
AU - Wang, Winfred C.
N1 - Funding Information:
This article is dedicated to the memory of Dr Chuck Pegelow and in gratitude for his support and guidance. We thank the patients, parents, and clinic staff members of the participating sickle cell clinics (Atlanta, Memphis, Oakland, Detroit, Brooklyn, Miami, Jackson, Miss, and Dallas). Case reports and census data were provided by Allan Platt, PA, Eldrida Carter-Randall MBA, Wendy Baughman, MSPH (Georgia Emerging Infections Program), Lewis Hsu, MD, PhD (Emory University); Janice Sanford, RN (St Jude Children's Research Hospital); Sandra Richardson (University of Texas Southwestern Medical Center); Beatrice Gee, MD (Morehouse School of Medicine); Ekua Hakney-Stephens, NP, and Jane Van Warmerdam, RN (Oakland Children's Hospital). Data for the population of African American children were compiled by Tamara Pilishvili (CDC Respiratory Branch). Laboratory support was provided by Ruth Franklin and Delois Jackson (CDC Respiratory Branch Streptococcal Reference Laboratory). We would like to thank John McGowan, MD, John R. Boring, PhD, and Mitchell Klein, PhD, for fruitful discussions and instructions (Emory K30/MSCR program) as well as Andrew Yeager, MD (Pittsburgh Children's Hospital), and Duane Bonds, MD (NHLBI), for their support. Manuscript preparation assistance was provided by Suzan Tibor and Pat Schwartzman. Complete univariate analysis is available upon request.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003/10
Y1 - 2003/10
N2 - Rates and severity of pneumococcal infections in children with sickle cell disease were examined before licensure of pneumococcal-conjugated vaccine (PVC). Rates of peak invasive infection rates in 1-year-old children with hemoglobin SS and mortality in those 0 to 10 years of age were 36.5 to 63.4 and 1.4 to 2.8 per 1000 person-years, respectively (>10 and 100 times as frequent as in the general population). Overall, 71% of serotyped isolates (n = 80) were PVC serotypes and 71% of nonvaccine serotype strains were penicillin-sensitive. Clinical presentation in children with hemoglobin SS (n = 71; more with hypotension) and hemoglobin SC (n = 18; more with acute chest syndrome, otitis media) differed. Penicillin nonsusceptibility (38% of isolates) varied between geographic study sites. Penicillin prophylaxis appeared less effective against intermediate and resistant strains. Of all infected children, meningitis developed in 20% and 15% died (hemoglobin SS, n = 15 and 11; hemoglobin SC, n = 1 each). Factors associated with death included age >4 years (58%), serotype 19F, and not being followed by a hematologist (42% each). The pneumococcal-polysaccharide vaccine was 80.4% effective within 3 years after vaccination (95% CI, 39.7, 93.6). Children with sickle cell disease of all ages may benefit from PVC boosted with polysaccharide vaccination.
AB - Rates and severity of pneumococcal infections in children with sickle cell disease were examined before licensure of pneumococcal-conjugated vaccine (PVC). Rates of peak invasive infection rates in 1-year-old children with hemoglobin SS and mortality in those 0 to 10 years of age were 36.5 to 63.4 and 1.4 to 2.8 per 1000 person-years, respectively (>10 and 100 times as frequent as in the general population). Overall, 71% of serotyped isolates (n = 80) were PVC serotypes and 71% of nonvaccine serotype strains were penicillin-sensitive. Clinical presentation in children with hemoglobin SS (n = 71; more with hypotension) and hemoglobin SC (n = 18; more with acute chest syndrome, otitis media) differed. Penicillin nonsusceptibility (38% of isolates) varied between geographic study sites. Penicillin prophylaxis appeared less effective against intermediate and resistant strains. Of all infected children, meningitis developed in 20% and 15% died (hemoglobin SS, n = 15 and 11; hemoglobin SC, n = 1 each). Factors associated with death included age >4 years (58%), serotype 19F, and not being followed by a hematologist (42% each). The pneumococcal-polysaccharide vaccine was 80.4% effective within 3 years after vaccination (95% CI, 39.7, 93.6). Children with sickle cell disease of all ages may benefit from PVC boosted with polysaccharide vaccination.
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U2 - 10.1067/S0022-3476(03)00331-7
DO - 10.1067/S0022-3476(03)00331-7
M3 - Article
C2 - 14571216
AN - SCOPUS:0242298737
SN - 0022-3476
VL - 143
SP - 438
EP - 444
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -