Todd P. ChangWorapant KriengsoontorkijLinda S. ChanVincent J. WangChildren's Hospital Los AngelesLos Angeles County USC Medical CenterKeck School of Medicine of USCMahidol University2018-10-192018-10-192013-07-01Journal of Pediatric Hematology/Oncology. Vol.35, No.5 (2013), 377-38215363678107741142-s2.0-84880313301https://repository.li.mahidol.ac.th/handle/20.500.14594/32279Objectives: The objective of this study was to determine the incidence of bacteremia in febrile sickle cell disease (SCD) children before and after the 7-valent pneumococcal vaccine (PCV7), and to determine clinical factors associated with bacteremia following PCV7. Patients and Methods: We reviewed all febrile events in SCD children from 1993 to 2009 at a tertiary care pediatric center, comparing general bacteremia and pneumococcal bacteremia incidence for 3 time periods around the PCV7. Univariate analysis and stepwise logistic regression identified clinical factors most associated with bacteremia in this population. Results: Of 466 SCD children identified, there were 2504 febrile events. We found 84 cases of bacteremia; 8 were pneumococcal. The general bacteremia incidence decreased significantly from 5.60% to 2.44% (P<0.001) over time. Pneumococcal bacteremia incidence did not decrease (P=0.13). Following PCV7, we identified 4 significant independent risk factors associated with general bacteremia: the presence of a central venous line, higher absolute band count, toxic appearance, and older age. Conclusions: In febrile SCD children, the incidence of general bacteremia decreased over time. No decrease in pneumococcal bacteremia was found. The presence of a central venous line, absolute band count, clinical appearance, and age may help predict bacteremia in this population. Copyright © 2013 by Lippincott Williams & Wilkins.Mahidol UniversityMedicineArticleSCOPUS10.1097/MPH.0b013e31828ac9e2