Background And Purpose: 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.
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