Bloodstream Infections in Adults with Sickle Cell Disease: Single-center Study

Abstract BACKGROUND: People with sickle cell disease (SCD) are more susceptible to bloodstream infections (BSIs). Several factors contribute to this heightened risk, including auto-splenectomy due to repeated sickling and ischemic injuries to the spleen and other tissues. Previous studies have mostly focused on BSI in pediatric populations, and this research aims to fill the gap in knowledge concerning BSIs in adult SCD patients. SUBJECTS AND METHODS: This was a retrospective cohort study. A cohort of patients known to have SCD between January 2016 and December 2020 were reviewed. A nonprobability consecutive sampling method was used. RESULTS: Two hundred and fifteen adult patients with SCD were included in this study. The study found that 5.2% of sickle cell patients had BSI based on blood culture results. Vaccination rates were relatively low, with only 70% vaccinated. Patients with BSI had a lower percentage of partial vaccination (36%–45%) than those without BSI (65%). Higher percentages of patients with BSI had high ferritin levels (>500) and iron overload documented by liver magnetic resonance imaging. Chronic lung disease was the most frequent comorbidity in patients with BSI, at 18%. The main source of BSI was the central line. Staphylococcus species were the most common causative organisms, followed by Enterobacteriaceae . CONCLUSION: Vaccination status, genotype, iron overload, iron chelation therapy, blood transfusions, and comorbidities play significant roles in the development of BSI. The findings highlight the importance of vigilant monitoring, infection prevention strategies, and early intervention to improve the outcomes and reduce the burden of BSI in this vulnerable population.