Hsiu-Mei Wei1, Yu-Lung Hsu1, Hsiao-Chuan Lin2, Tsung-Hsueh Hsieh1, Ting-Yu Yen1, Hung-Chih Lin3, Bai-Horng Su3, Kao-Pin Hwang4. 1. Division of Infectious Diseases, Children's Hospital, China Medical University and China Medical University Hospital, Taichung, Taiwan. 2. Division of Infectious Diseases, College of Medicine and Department of Pediatrics, Children's Hospital of China Medical University and China Medical University Hospital, Taichung, Taiwan. 3. Division of Neonatology, College of Medicine and Department of Pediatrics, Children's Hospital of China Medical University and China Medical University Hospital, Taichung, Taiwan. 4. Division of Infectious Diseases, College of Medicine and Department of Pediatrics, Children's Hospital of China Medical University and China Medical University Hospital, Taichung, Taiwan. Electronic address: kapihw@mail.cmuh.org.tw.
Abstract
BACKGROUND: Few studies have focused on multidrug-resistant Acinetobacter baumannii (MDRAB) infection in neonates. The aim of this study was to investigate risk factors for mortality in neonates with MDRAB infection. METHODS: This retrospective case-series study was conducted at the Children's Hospital of China Medical University, Taichung, Taiwan. All patients hospitalized between January 2010 and December 2013 in the neonatal intensive care unit (NICU) with MDRAB infections were reviewed. RESULTS: A total of 67 isolates from 59 neonatal patients were positive for MDRAB. Of the 67 isolates, 38 were from blood (56.72%), 16 from sputum (23.88%), seven from pus (10.45%), three from ascites (4.48%), two from cerebrospinal fluid (2.99%), and one from pleural fluid (1.49%). There were five episodes of MDRAB clusters consisting of 28 cases during the study period. The mortality rate due to MDRAB sepsis was 20.34% (12/59). The statistically significant risk factors for mortality due to MDRAB infection were being infected with MDRAB within 7 days of admission to the NICU, use of umbilical vein catheters, absolute neutrophil count < 1500/mm(3), platelet count < 100,000/mm(3), and a delay in initiating adequate antibiotic treatment. CONCLUSION: MDRAB infection is responsible for a high mortality rate among neonates in the NICU, especially in those who have neutropenia or thrombocytopenia. Infection control and appropriateness of the initial antimicrobial agent with colistin play an important role in reducing mortality.
BACKGROUND: Few studies have focused on multidrug-resistant Acinetobacter baumannii (MDRAB) infection in neonates. The aim of this study was to investigate risk factors for mortality in neonates with MDRAB infection. METHODS: This retrospective case-series study was conducted at the Children's Hospital of China Medical University, Taichung, Taiwan. All patients hospitalized between January 2010 and December 2013 in the neonatal intensive care unit (NICU) with MDRAB infections were reviewed. RESULTS: A total of 67 isolates from 59 neonatal patients were positive for MDRAB. Of the 67 isolates, 38 were from blood (56.72%), 16 from sputum (23.88%), seven from pus (10.45%), three from ascites (4.48%), two from cerebrospinal fluid (2.99%), and one from pleural fluid (1.49%). There were five episodes of MDRAB clusters consisting of 28 cases during the study period. The mortality rate due to MDRAB sepsis was 20.34% (12/59). The statistically significant risk factors for mortality due to MDRAB infection were being infected with MDRAB within 7 days of admission to the NICU, use of umbilical vein catheters, absolute neutrophil count < 1500/mm(3), platelet count < 100,000/mm(3), and a delay in initiating adequate antibiotic treatment. CONCLUSION:MDRAB infection is responsible for a high mortality rate among neonates in the NICU, especially in those who have neutropenia or thrombocytopenia. Infection control and appropriateness of the initial antimicrobial agent with colistin play an important role in reducing mortality.
Authors: Ming Ying Gan; Wen Li Lee; Bei Jun Yap; Shu Ting Tammie Seethor; Rachel G Greenberg; Jen Heng Pek; Bobby Tan; Christoph Paul Vincent Hornik; Jan Hau Lee; Shu-Ling Chong Journal: Front Pediatr Date: 2022-06-03 Impact factor: 3.569
Authors: Lynn Peters; Linus Olson; Dung T K Khu; Sofia Linnros; Ngai K Le; Håkan Hanberger; Ngoc T B Hoang; Dien M Tran; Mattias Larsson Journal: PLoS One Date: 2019-05-08 Impact factor: 3.240