title: [Microbiological features and risk factors for acquiring multidrug-resistant Acinetobacter baumannii bacteremia in pediatric patients. Case-control study].
abstract: BACKGROUND
  Multidrug-resistant Acinetobacter baumannii (MAB) is an important nosocomial pathogen.
  
  
  OBJECTIVE
  To analyze the risk factors for acquiring MAB, and the clinical and microbiological characteristics of MAB bacteremia (MABB) in children.
  
  
  METHODS
  Control-case study 2005-2008. Demographic and clinical data from all MABB and from non-multiresistant gram-negative bacteremias were recorded. Identification at species level, antimicrobial susceptibility tests, time-kill studies and clonally relationships were performed. Stata 8.0 was used for data analysis.
  
  
  RESULTS
  A total of 50 MABB and 100 controls were included. Ninety four percent of patients acquired MAB in ICU and the 88% had underlying diseases. All patients had invasive procedures previous to MABB. The median of hospitalization stay previous to MABB was different in cases than in controls (16 vs 7 days, p < 0.001). Five clones were detected among the MABB. Time-killing curves showed bactericidal activity of ampicillin/sulbactam plus gentamicin and polymixin B. Three patients with MAB died. In a multivariate analysis final predictors of MABB were: previous use of broad-spectrum antibiotics [OR: 7,0; IC 95% 1,93-25,0; p: 0,003] and mechanical ventilation [OR: 4,19; IC 95% 1,66-10,0; p: 0,002].
  
  
  CONCLUSIONS
  MABB were detected in patients with underlying conditions, invasive procedures and prolonged hospitalization. Predictors of MABB were mechanical previous use of broad-spectrum antibiotics and mechanical ventilation.
authors: Silvina
authors: S
authors: Ruvinsky
authors: Graciela
authors: G
authors: Fiorilli
authors: M Guadalupe
authors: MG
authors: Pérez
authors: Eduardo
authors: E
authors: Motto
authors: Carlos
authors: C
authors: Cambaceres
authors: Leonardo
authors: L
authors: Mannino
authors: Horacio
authors: H
authors: Lopardo
authors: Rosa
authors: R
authors: Bologna
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D016022:Case-Control Studies; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003091:Colistin / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008826:Microbial Sensitivity Tests; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003091:Colistin