Multidrug-resistant Acinetobacter baumannii isolates in pediatric patients of a university hospital in Taiwan.
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.
Chang
Po Yang
PY
Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Lu-Gang, Taiwan.
Hsueh
Po Ren
PR
Wu
Ping Sheng
PS
Chan
Pei Chun
PC
Yang
Tsao Ton
TT
Lu
Chun Yi
CY
Chang
Luan Yin
LY
Chen
Jung Min
JM
Lee
Ping Ing
PI
Lee
Chin Yun
CY
Huang
Li Min
LM
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