Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria

This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin.One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml) on two consecutive cultures were regarded as having asymptomatic bacteriuria.Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1) when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%). All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones.The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.Urinary tract infection (UTI) is a common cause of renal disorder in the tropics[1] and causes significant morbidity[2,3] and mortality[4] in children, especially when it is asymptomatic, not detected and treated promptly.Sickle cell anemia is common in Nigeria with prevalence values ranging from 2% to 3% of the population [5,6] and is associated with increased frequency and severity of infections especially with encapsulated bacteria such as Streptococcus pneumoniae and Haemophilus influenza as well as salmonella and Escherichia coli. Children with sickle cell anemia have increased susceptibility to develop UTI because of altered blood flow in the renal vasculature which causes papillary necrosis and l