Nosocomial Acinetobacter baumannii infection in children in adult versus pediatric intensive care units

Abstract

Background: We hypothesized that children treated in adult intensive care units (ICUs) might be at increased risk of hospital-acquired infection. We therefore compared the incidence of Acinetobacter baumannii infection in children treated in pediatric ICUs (PICUs) and in those treated in adult ICUs. Methods: Patients aged <18 years admitted to PICUs or adult ICUs between March 2009 and June 2017 were enrolled. We retrospectively investigated A. baumannii isolates and calculated the A. baumannii incidence during ICU admission. Cox regression was used to identify possible risk factors for A. baumannii infection. Results: Eight hundred and thirty ICU cases were included; 508 were treated in PICUs ("PICU group") and 322 in adult ICUs ("adult-ICU group"). Acinetobacter baumannii was isolated 19 (3.7%) and 23 (7.1%) times in the PICU and adult-ICU groups, respectively. Incidence densities for A. baumannii acquisition in PICU and adult-ICU groups were 1.63 and 5.62 per 1,000 ICU days, respectively. In the Cox regression model, the hazard ratio for A. baumannii acquisition associated with treatment in PICUs was 0.33 (95% confidence interval: 0.17-0.61; P = 0.001). In multivariate analysis after adjusting for age and sex, treatment in PICU remained significantly associated with a reduced risk of A. baumannii infection (hazard ratio: 0.40; 95%; confidence interval: 0.20-0.76). Conclusions: Pediatric patients treated in a PICU had a lower rate and incidence density of A. baumannii nosocomial infection than those treated in adult ICUs, suggesting that PICUs provide better infection control for children than adult ICUs.

The Investigation on Nosocomial Infection of Acinetobacter baumannii and the Clinical Analysis of Sequential Therapy of Cefoperazone/Sulbactam Sodium for Intracranial Infection

“…And the risk factors causing intracranial infection with Acinetobacter baumannii have been discussed clinically [ 1 ]. Active anti-infective therapy is the first choice for intracranial infection; however, the anti-infective treatment of intracranial infection requires not only strong killing effect on pathogens but also the ability to penetrate the blood-brain barrier and achieve high drug concentration locally [ 2 ].…”

Multidrug resistant and extensively drug resistant Acinetobacter baumannii hospital infection associated with high mortality: a retrospective study in the pediatric intensive care unit

“…In pediatric critically ill patients, underlying diseases, immune deficiency, and invasive operations all contributed to the higher incidence of multidrug resistant Acinetobacter baumannii infection [13]. Multidrug resistant Acinetobacter baumannii infection is responsible for a high mortality rate among neonates in the NICU [14].…”

Controlling an Outbreak of Multidrug-resistant Acinetobacter baumannii in a Pediatric Intensive Care Unit: a Retrospective Analysis

“…The MDRAB-associated mortality rate exceeds 25%, and even reaches 75% depending on several factors. 10 28 29 30 Importantly, antibiotic susceptibility is the most fundamental factor when treating MRDAB infections. 6 9 Fortunately, the MDRAB strain was susceptible to colistin and intermediately susceptible to amoxicillin/sulbactam; otherwise, the outbreak would have resulted in several fatal cases due to the MDRAB infection.…”