- 作者：Jen-Fu Hsu ; Shih-Ming Chu ; Reyin Lien ; Cheng-Hsun Chiu ; Ming-Chou Chiang ; Ren-Huei Fu ; Chiang-Wen Lee ; Hsuan-Rong Huang ; Ming-Horng Tsai
- 关键词：Late-onset sepsis ; Gram-negative bacteremia ; Multidrug resistance ; Neonate ; Recurrence
- 刊名：American Journal of Infection Control
- 出版年：January, 2014
- 年：2014
- 卷：42
- 期：1
- 页码：23-27
- 全文大小：265 K
Background
We aimed to characterize the clinical manifestations and outcomes of patients with Acinetobacter baumannii bacteremia in the neonatal intensive care unit (NICU).Methods
All patients with A baumannii bacteremia in our NICU from 2004 to 2010 were reviewed. A matched case-control study was performed by comparing each case of A baumannii to 2 uninfected controls and all cases of Escherichia coli and Klebsiella bacteremia, respectively.
Results
Thirty-seven cases with A baumannii bacteremia were identified. Multidrug-resistant isolate was noted in only 2 cases (5.4%), and the overall mortality rate was 8.1%. Compared with matched, uninfected controls, infants with A baumannii were more likely to have had a central vascular catheter (CVC) (P聽= .009), use of total parenteral nutrition (TPN) (P聽= .021), longer duration of ventilator use (P聽= .002), and hospitalization (P聽= .010). Compared with E coli or Klebsiella bacteremia, infants with A baumannii bacteremia had lower birth weight (median of 1,090 g vs 1,300 g, P聽= .044) and a higher rate of CVC and TPN use (both P < .001) at the time of infection.
Conclusion
A baumannii bacteremia occurs endemically or sporadically in the NICU, primarily in low-birth-weight infants on TPN use and with CVC in situ. Although A baumannii does not often cause mortality, and multidrug-resistant A baumannii is uncommon, it contributes significantly to longer hospitalization.