Multidrug-resistant Acinetobacter baumannii isolates in pediatric patients of a university hospital in Taiwan
Po-Yang Chang, Po-Ren Hsueh, Ping-Sheng Wu, Pei-Chun Chan, Tsao-Ton Yang, Chun-Yi Lu, Luan-Yin Chang, Jung-Min Chen, Ping-Ing Lee, Chin-Yun Lee, Li-Min Huang
Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Lu-Gang; and Departments of 2Laboratory Medicine and Internal Medicine, and 3Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
Received: March 20, 2006 Revised: August 20, 2006 Accepted: August 30, 2006
Background and purpose:
Acinetobacter baumannii is one of the common nosocomial pathogens, and the emergence of multidrug-resistant A. baumannii (MDRAB) is a therapeutic problem. We describe the clinical characteristics and outcomes of MDRAB colonization/infection in pediatric patients at the National Taiwan University Hospital.
Fifty two pediatric patients with 205 MDRAB isolates collected between April 2000 and December 2005 were included for investigation of their clinical characters, presentations, and outcome.
Among these 205 isolates, 20 (9.8%) were from sterile body sites (11 from blood, 8 from catheter tips, and 1 from ascites), 154 (75.1%) from respiratory sites, 18 (8.8%) from skin or wound pus, 5 (2.4%) from urine, and 8 (3.9%) from other sites. The mean age was 6 years. The common underlying diseases were haematological or oncological diseases (n = 15, 28.8%), neonatal disorders (6, 11.5%), cyanotic congenital heart diseases (10, 19.2%), neurology disorders (12, 23.1%), and gastrointestinal tract disorders (3, 5.8%). Seventeen patients (32.7%) had received major surgery, and 48 (92.3%) had used ventilators. Fourteen patients (26.9%) had neutropenia and 46 (88.5%) had used broad-spectrum antibiotics. There were 31 patients (59.6%) with suspected or proven MDRAB infections, including sepsis (9 patients), pneumonia (19), wound infections (3), urinary tract infections (2), peritonitis (1), and perineal infection (1). Seven (77.8%) of the 9 sepsis patients died. The overall mortality rate was 42.3% (22 cases).
The threat of MDRAB has been recognized in our hospital for several years. Host defense deficiencies, prolonged intensive care unit hospitalizations, and prior broad-spectrum antibiotic use play a major role in MDRAB infection and colonization.
Acinetobacter baumannii; Drug resistance, multiple, bacterial; Pediatrics
J Microbiol Immunol Infect. 2007;40:406-410.