title: Characteristics of invasive Acinetobacter species isolates recovered in a pediatric academic center.
abstract: Acinetobacter species are associated with increasing mortality due to emerging drug-resistance. Pediatric Acinetobacter infections are largely undefined in developed countries and clinical laboratory identification methods do not reliably differentiate between members of the Acinetobacter calcoaceticus-baumannii complex, leading to improper identification. Therefore we aimed to determine risk factors for invasive Acinetobacter infections within an academic, pediatric setting as well as defining microbiologic characteristics of predominant strains.
  
  
  
  Twenty-four invasive Acinetobacter isolates were collected from 2009-2013. Comparative sequence analysis of the rpoB gene was performed coupled with phenotypic characterization of antibiotic resistance, motility, biofilm production and clinical correlation.
  
  
  
  Affected patients had a median age of 3.5 years, and 71 % had a central catheter infection source. rpoB gene sequencing revealed a predominance of A. pittii (45.8 %) and A. baumannii (33.3 %) strains. There was increasing incidence of A. pittii over the study. Two fatalities occurred in the A. pittii group. Seventeen percent of isolates were multi-drug resistant. A pittii and A. baumannii strains were similar in motility, but A pittii strains had significantly more biofilm production (P value = 0.018).
  
  
  
  A. pittii was the most isolated species highlighting the need for proper species identification. The isolated strains had limited acute mortality in children, but the occurrence of more multi-drug resistant strains in the future is a distinct possibility, justifying continued research and accurate species identification.
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Avish L
authors.initials: AL
authors.lastname: Jain
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.|Biomedical Sciences Graduate Program, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Harding
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Kaivon
authors.initials: K
authors.lastname: Assani
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Chandra L
authors.initials: CL
authors.lastname: Shrestha
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Mercedees
authors.initials: M
authors.lastname: Haga
authors.affiliation: Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Leber
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Munson
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. Benjamin.Kopp@NationwideChildrens.org.|Nationwide Children's Hospital, Section of Pulmonary Medicine, 700 Children's Drive, Columbus, OH, 43205, USA. Benjamin.Kopp@NationwideChildrens.org.
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Kopp
mesh_terms: D000046:Academic Medical Centers; D000150:Acinetobacter / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D018441:Biofilms; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acinetobacter; Antibiotic resistance; Bacteremia; Pediatric