title: Risk Factors and Predictors of Mortality in Critically ill Children with Extensively-Drug Resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit.
abstract: OBJECTIVE
  Acinetobacter baumannii is an important emerging cause for extensively-drug resistant (XDR) hospital associated infections (HAIs) in pediatric intensive care units (PICU). The study was done to evaluate the risk factors, outcome, antibiotic sensitivity pattern, and predictors of mortality in critically ill children with XDR A. baumannii infection.
  
  
  METHODS
  Retrospective case control study, done in the PICU of a tertiary care pediatric hospital of India from April 2010 to March 2012.
  
  
  RESULTS
  Eighty-five children who developed XDR A. baumannii infection matched to 170 controls. Majority (76%) of the organisms were isolated from endotracheal lavage. The mortality rate was 28.2% (24/85). The factors found to be significantly associated with A. baumannii infection were prior use of broad-spectrum antibiotics, major surgeries done, prolonged PICU stay, use of central venous catheters, and mechanical ventilation. The predictors of mortality associated with A. baumannii infection were acute kidney injury, presence of septic shock, and disseminated intravascular coagulopathy. Colistin found to be the single most effective drug against XDR A. baumannii infection.
  
  
  CONCLUSIONS
  XDR A. baumannii infections are associated with high morbidity and mortality in critically ill children. Early diagnosis and treatment are crucial. Implementation of infection control practices and rational use of antibiotics are required to control such infections.
authors: Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
authors: Kapil
authors: K
authors: Kapoor
authors: Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
authors: Sumidha
authors: S
authors: Jain
authors: Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
authors: Mamta
authors: M
authors: Jajoo
authors: Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
authors: Swati
authors: S
authors: Dublish
authors: Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
authors: Vikas
authors: V
authors: Dabas
authors: Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
authors: Vikas
authors: V
authors: Manchanda
keywords: Acinetobacter Baumannii; Children; Extensively-Drug Resistant; Hospital Associated Infection