Jen-Fu Hsu1, Shih-Ming Chu1, Reyin Lien1, Cheng-Hsun Chiu2, Ming-Chou Chiang1, Ren-Huei Fu1, Chiang-Wen Lee3, Hsuan-Rong Huang1, Ming-Horng Tsai4. 1. Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. 2. College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Infectious Disease, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 3. Chang Gung University of Science and Technology, Chiayi, Taiwan. 4. College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Infectious Disease, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Neonatology and Pediatric Hematology/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan. Electronic address: mingmin.tw@yahoo.com.tw.
Abstract
BACKGROUND: We aimed to characterize the clinical manifestations and outcomes of patients with Acinetobacter baumannii bacteremia in the neonatal intensive care unit (NICU). METHODS: All patients with A baumannii bacteremia in our NICU from 2004 to 2010 were reviewed. A matched case-control study was performed by comparing each case of A baumannii to 2 uninfected controls and all cases of Escherichia coli and Klebsiella bacteremia, respectively. RESULTS: Thirty-seven cases with A baumannii bacteremia were identified. Multidrug-resistant isolate was noted in only 2 cases (5.4%), and the overall mortality rate was 8.1%. Compared with matched, uninfected controls, infants with A baumannii were more likely to have had a central vascular catheter (CVC) (P = .009), use of total parenteral nutrition (TPN) (P = .021), longer duration of ventilator use (P = .002), and hospitalization (P = .010). Compared with E coli or Klebsiella bacteremia, infants with A baumannii bacteremia had lower birth weight (median of 1,090 g vs 1,300 g, P = .044) and a higher rate of CVC and TPN use (both P < .001) at the time of infection. CONCLUSION: A baumannii bacteremia occurs endemically or sporadically in the NICU, primarily in low-birth-weight infants on TPN use and with CVC in situ. Although A baumannii does not often cause mortality, and multidrug-resistant A baumannii is uncommon, it contributes significantly to longer hospitalization. Crown
BACKGROUND: We aimed to characterize the clinical manifestations and outcomes of patients with Acinetobacter baumannii bacteremia in the neonatal intensive care unit (NICU). METHODS: All patients with A baumannii bacteremia in our NICU from 2004 to 2010 were reviewed. A matched case-control study was performed by comparing each case of A baumannii to 2 uninfected controls and all cases of Escherichia coli and Klebsiella bacteremia, respectively. RESULTS: Thirty-seven cases with A baumannii bacteremia were identified. Multidrug-resistant isolate was noted in only 2 cases (5.4%), and the overall mortality rate was 8.1%. Compared with matched, uninfected controls, infants with A baumannii were more likely to have had a central vascular catheter (CVC) (P = .009), use of total parenteral nutrition (TPN) (P = .021), longer duration of ventilator use (P = .002), and hospitalization (P = .010). Compared with E coli or Klebsiella bacteremia, infants with A baumannii bacteremia had lower birth weight (median of 1,090 g vs 1,300 g, P = .044) and a higher rate of CVC and TPN use (both P < .001) at the time of infection. CONCLUSION:A baumannii bacteremia occurs endemically or sporadically in the NICU, primarily in low-birth-weight infants on TPN use and with CVC in situ. Although A baumannii does not often cause mortality, and multidrug-resistant A baumannii is uncommon, it contributes significantly to longer hospitalization. Crown
Authors: Richard Chawana; Vicky Baillie; Alane Izu; Fatima Solomon; Quique Bassat; Dianna M Blau; Robert F Breiman; Martin Hale; Eric R Houpt; Sanjay G Lala; Roosecelis B Martines; Azwifarwi Mathunjwa; Susan Nzenze; Jayani Pathirana; Karen L Petersen; Pratima L Raghunathan; Jana M Ritter; Jeannette Wadula; Sherif R Zaki; Shabir A Madhi Journal: Clin Infect Dis Date: 2019-10-09 Impact factor: 9.079