Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-24T16:07:58.489Z Has data issue: false hasContentIssue false

Nosocomial Infection in Adult Patients with Sickle Cell Anemia

Published online by Cambridge University Press:  21 June 2016

Helen M. Crowe
Affiliation:
Department of Medicine, Boston University School of Medicine, Division of Infectious Diseases, Boston City Hospital, Boston, Massachusetts
Deborah A. Lichtenberg
Affiliation:
Department of Medicine, Boston University School of Medicine, Division of Infectious Diseases, Boston City Hospital, Boston, Massachusetts
Donald E. Craven*
Affiliation:
Department of Medicine, Boston University School of Medicine, Division of Infectious Diseases, Boston City Hospital, Boston, Massachusetts
*
Boston City Hospital, 818 Harrison Ave., Boston, MA 02118

Abstract

Although the vulnerability of patients with sickle cell disease to infection with encapsulated organisms is well recognized, nosocomial transmission of infection has not been studied in this population. We describe eight serious, nosocomially transmitted infections in four adult patients hospitalized for complications of sickle cell disease, which led to death in one patient and prolonged hospital stays in three others. Although we have not surveyed all patients with sickle cell disease for rates of nosocomial infection, the cases presented suggest that these patients may be at increased risk. Risk can be reduced if health care workers are especially vigilant in adhering to handwashing and other infection control measures when caring for these patients. Additionally, we recommend that a patient with sickle cell disease not share a room with a patient known to have or suspected of having a nosocomial or community-acquired infectious disease.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Barrett-Connor, E: Bacterial infection and sickle cell anemia. Medicine 1971; 50:97112.CrossRefGoogle ScholarPubMed
2. Johnston, RB: Increased susceptibility to infection in sickle cell disease. South Med J 1974; 67:13421348.CrossRefGoogle ScholarPubMed
3. Robinson, MG, Halpern, C: Infections, Escherichia coli and sickle cell anemia. JAMA 1974; 230:11451148.CrossRefGoogle ScholarPubMed
4. Winkelstein, JA, Drachman, RH: Deficiency of pneumococcal serum opsonizing activity in sickle-cell disease. N Engl J Med 1968; 279:459466.CrossRefGoogle ScholarPubMed
5. Pearson, HA, Spencer, RP, Cornelius, EA: Functional asplenia in sickle-cell anemia. N Engl J Med 1969; 281:923926.CrossRefGoogle ScholarPubMed
6. Johnston, RB, Newman, SL, Struth, AG: An abnormality of the alternate pathway of complement activation in sickle cell disease. N Engl J Med 1973; 288:803808.CrossRefGoogle ScholarPubMed
7. Pearson, HA: Sickle cell anemia and severe infections due to encapsulated bacteria. J Infect Dis 1977; 136:S25S30.CrossRefGoogle ScholarPubMed
8. Robinson, MG, Watson, RJ: Pneumococcal meningitis in sickle-cell anemia. N Engl J Med 1966; 274:10061008.CrossRefGoogle ScholarPubMed
9. Overturf, GD. Powars, D. Baraff, LJ: Bacterial meningitis and septicemia in sickle cell disease. Am J Dis Child 1977: 131:784787.Google ScholarPubMed
10. Gaston, MH. Verter, JI, Woods, G. et al: Prophylaxis with oral penicillin in children with sickle cell anemia. N Engl J Med 1986: 314:15931599.CrossRefGoogle ScholarPubMed
11. Craven, DE, Reed, C, Kollisch, N, et al: A large outbreak of infections caused by a strain of Staphylococcus aureus resistant to oxacillin and aminoglycosides. Am J Med 1981; 71:5358.CrossRefGoogle ScholarPubMed
12. Bromberg, PA: Pulmonary aspects of sickle cell disease. Arch Intern Med 1974; 133:652657.CrossRefGoogle Scholar
13. Young, LS: Nosocomial infections in the immunocompromised adult. Am J Med 1981: 70:398404.CrossRefGoogle ScholarPubMed
14. Zuraleff, JJ. Yu, VL: Infections caused by Pseudomonas maltophilia with emphasis on bacteremia: Case reports and a review of the literature. Rev Infect Dis 1982; 4:12361246.CrossRefGoogle Scholar
15. Craven, DE. Kunches, LM. Lichtenberg, DA, et al: Risk factors for nosocomial infection and fatality in medical and surgical intensive care unit patients. Arch Intern Med 1988; 148:11611168.CrossRefGoogle ScholarPubMed
16. Hook, EW, Campbell, CG, Weens, HS, et al: Salmonella osteomyelitis in patients with sickle-cell anemia. N Engl J Med 1957; 257:403407.CrossRefGoogle ScholarPubMed
17. Weinberg, ED: Iron and infection. Microbiol Rev 1978; 42:4566.CrossRefGoogle ScholarPubMed
18. Arbeit, RD, Karakawa, WW, Vann, WF, et al: Predominance of two newly described capsular polysaccharide types among clinical isolates of Staphylococcus aureus . Diagn Microbiol Infect Dis 1984; 2:8591.CrossRefGoogle ScholarPubMed