Septicaemia in sickle cell anaemia patients: the Ibadan experience

Abstract

Objective: To describe the pattern of septicaemia among sickle cell anaemia patients.

Design: Descriptive study.

Setting: Haematology Day Care Unit of the University College Hospital, Ibadan, Nigeria.

Subjects: 269 patients with sickle cell anaemia who presented with fever greater than 38 degrees C.

Results: The blood of 97 of the patients exhibited positive growth with isolation of bacteria thereby confirming the diagnosis of septicaemia in them. Fifty seven (59%) of the isolates were gram negative while 40 (41%) were gram positive pathogens. Klebsiella sp. was the predominant gram negative bacteria while Staphylococcus aureus was the predominant gram positive bacteria. The sensitivity tests on the isolates confirmed Ceftozidine (Fortum) was the most effective antibacterial agent for the gram negative and gram positive pathogens. The 172 patients, who had no bacteria pathogens isolated did well with prophylactic broad spectrum antibiotics. Thirty one patients with positive malarial parasites had full anti-malarial therapy.

Conclusion: The incidence of gram negative septicaemia is high in patients with sickle cell anaemia. Klebsiella spp. is the predominant gram negative bacterium while Staphylococcus aureus is the predominant gram positive bacterium. Ceftozidine appears to be the most effective antibiotic against both the gram positive and gram negative bacterial infection.