title: Multidrug-resistant Acinetobacter baumannii isolates in pediatric patients of a university hospital in Taiwan.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Lu-Gang, Taiwan.
authors.forename: Po Yang
authors.initials: PY
authors.lastname: Chang
authors.forename: Po Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: Ping Sheng
authors.initials: PS
authors.lastname: Wu
authors.forename: Pei Chun
authors.initials: PC
authors.lastname: Chan
authors.forename: Tsao Ton
authors.initials: TT
authors.lastname: Yang
authors.forename: Chun Yi
authors.initials: CY
authors.lastname: Lu
authors.forename: Luan Yin
authors.initials: LY
authors.lastname: Chang
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chen
authors.forename: Ping Ing
authors.initials: PI
authors.lastname: Lee
authors.forename: Chin Yun
authors.initials: CY
authors.lastname: Lee
authors.forename: Li Min
authors.initials: LM
authors.lastname: Huang
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010502:Perineum / Q000382:microbiology; D010538:Peritonitis / Q000382:microbiology; D011014:Pneumonia / Q000382:microbiology; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology; D013624:Taiwan / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000382:microbiology; D014946:Wound Infection / Q000382:microbiology