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Respiratory pathogens and acute chest syndrome in children with sickle cell disease
  1. Marie-Caroline Ploton1,2,
  2. Julie Sommet3,
  3. Bérengère Koehl4,
  4. Jean Gaschignard1,
  5. Laurent Holvoet4,
  6. Patricia Mariani-Kurkdjian5,
  7. Malika Benkerrou4,
  8. Enora Le Roux6,7,
  9. Stephane Bonacorsi5,8,
  10. Albert Faye1,8
  1. 1 Department of General Pediatrics and infectious diseases, Hôpital Universitaire Robert-Debré, Paris, France
  2. 2 Department of General Pediatrics, Hôpital Nord Ouest, Villefranche, France
  3. 3 Department of Pediatric Intensive Care, Hôpital Universitaire Robert Debré, Paris, France
  4. 4 Reference Center of Sickle Cell Disease, Hôpital Universitaire Robert-Debré, Paris, France
  5. 5 Laboratory of Microbiology, Hôpital Universitaire Robert Debré, Paris, France
  6. 6 Clinical Research Unit, Hôpital Universitaire Robert Debré, Paris, France
  7. 7 ECEVE INSERM 1123, Université de Paris, Paris, France
  8. 8 Université de Paris, Paris, France
  1. Correspondence to Professor Albert Faye, Service de pédiatrie générale, maladies infectieuses et medecine interne, Hopital Universitaire Robert Debre, Paris, France; albert.faye{at}aphp.fr

Abstract

Background Acute chest syndromes (ACS) may be associated with upper respiratory tract infections, but the epidemiology of viral and intracellular respiratory pathogens in children with sickle cell disease (SCD) is not precisely known. The aim of this study was to describe the epidemiology of viral and intracellular respiratory pathogens in children with SCD presenting with fever and/or ACS.

Materials and methods An observational, prospective, single-centre cohort study with nested case–control analysis was conducted on children with SCD admitted from October 2016 to October 2017 for fever and/or ACS to the paediatric department of Robert Debré university hospital, Paris, France. They were screened for 20 respiratory pathogens by a multiplex PCR in the nasopharynx (FilmArray).

Results We included 101 children. M/F sex ratio of 0.45. The median age was 3.2 years (IQR: 1.4–8.2). At least one pathogen was isolated in 67 patients (67%). The most frequent viruses were as follows: rhinovirus (n=33), adenovirus (n=14), respiratory syncytial virus (n=13) and parainfluenza viruses (n=11). Mycoplasma pneumoniae was detected in one case. Twenty-three (23%) presented with or developed ACS. A nested case–control analysis was performed, after pairing ACS with non-ACS children for age and inclusion period. There was no statistical association between any viral detection or multiple viral infection, and ACS (p=0.51) even though parainfluenza viruses were twice as common in ACS.

Conclusions Viral detection in febrile children with SCD is frequent, but its association with ACS was not demonstrated. In this study, M. pneumoniae was rare in young children with SCD experiencing ACS.

  • epidemiology
  • general paediatrics
  • haematology
  • infectious diseases
  • virology
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Footnotes

  • Contributors M-CP substantially contributed to the conception and design of this article, reviewed the literature, summarised and analysed the literature data and drafted the initial manuscript. She critically reviewed the manuscript for important intellectual content and reviewed and revised the manuscript. JS substantially contributed to the conception and design of this article and data statistical analysis, critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. BK substantially contributed to the conception and design of this article, supported the literature review, critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. JG substantially contributed to the data collection of this article, supported literature review, critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. LH critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. PM-K substantially contributed to the data collection. She critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. MB critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. ELR substantially contributed to the conception and design of this article, supported the literature review, led the data statistical analysis, critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. SB substantially contributed to the conception and design of this article and to the data collection. He critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. AF substantially contributed to the conception and design of this article and to the data collection. He supported the literature review, critically reviewed the manuscript for important intellectual content, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study design was reviewed and accepted by Robert Debré Hospital’s local ethical committee IRB n°2016/2962 and data collection was approved by the national informatics and freedoms commission (n°1 967 433 v 0)

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are available upon reasonnable request made to corresponing author.

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