Multidrug-resistant Acinetobacter baumannii infection among neonates in a neonatal intensive care unit at a medical center in central Taiwan

Hsiu Mei Wei, Yu Lung Hsu, Hsiao Chuan Lin, Tsung Hsueh Hsieh, Ting Yu Yen, Hung Chih Lin, Bai Horng Su, Kao Pin Hwang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

22 Scopus citations

Abstract

Background: Few studies have focused on multidrug-resistant Acinetobacter baumannii (MDRAB) infection in neonates. The aim of this study was to investigate risk factors for mortality in neonates with MDRAB infection. Methods: This retrospective case-series study was conducted at the Children's Hospital of China Medical University, Taichung, Taiwan. All patients hospitalized between January 2010 and December 2013 in the neonatal intensive care unit (NICU) with MDRAB infections were reviewed. Results: A total of 67 isolates from 59 neonatal patients were positive for MDRAB. Of the 67 isolates, 38 were from blood (56.72%), 16 from sputum (23.88%), seven from pus (10.45%), three from ascites (4.48%), two from cerebrospinal fluid (2.99%), and one from pleural fluid (1.49%). There were five episodes of MDRAB clusters consisting of 28 cases during the study period. The mortality rate due to MDRAB sepsis was 20.34% (12/59). The statistically significant risk factors for mortality due to MDRAB infection were being infected with MDRAB within 7 days of admission to the NICU, use of umbilical vein catheters, absolute neutrophil count < 1500/mm3, platelet count < 100,000/mm3, and a delay in initiating adequate antibiotic treatment. Conclusion: MDRAB infection is responsible for a high mortality rate among neonates in the NICU, especially in those who have neutropenia or thrombocytopenia. Infection control and appropriateness of the initial antimicrobial agent with colistin play an important role in reducing mortality.

Original languageEnglish
Pages (from-to)531-539
Number of pages9
JournalJournal of Microbiology, Immunology and Infection
Volume48
Issue number5
DOIs
StatePublished - 10 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014.

Keywords

  • Acinetobacter baumannii
  • Mortality
  • Multidrug-resistant
  • Neonatal intensive care unit
  • Neonate

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