Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India

  • Ajay Kumar Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital
  • Valinderjeet Singh Randhawa Lady Hardinge Medical College, New Delhi, India
  • Nilay Nirupam Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India
  • Yogita Rai Lady Hardinge Medical College, New Delhi, India
  • Arvind Saili Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India
Keywords: sepsis, colistin, neonates, multiresistant organism, health care associated infections, nosocomial sepsis

Abstract

Introduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is being increasingly observed and is associated with significant morbidity and mortality in newborns.

In this study, we determined the epidemiology, risk factors, and outcomes of blood stream infection (BSI) caused by CRAB in neonates.

Methodology: The clinical charts of neonates who developed Acinetobacter baumannii BSI in the period between 1 January 2010 and 31 December 2012 were reviewed.

Results: During the study period, 65 neonates developed Acinetobacter baumannii BSI; 33 were CRAB at an incidence of 0.50 case per 1,000 patient-days. Compared with carbapenem-sensitive Acinetobacter baumannii (CSAB), patients with CRAB BSI had significantly higher prior antimicrobial use, longer duration of ventilation, and late isolation of organisms. Feeding with expressed breast milk was protective. All isolates of Acinetobacter baumenii were sensitive to colistin and tigecycline. The all-cause mortality rates were 27.3% in CRAB and 9.4% in CSAB BSI, respectively (p = 0.074).

Conclusions: Neonatal BSI caused by CRAB was not common but caused high mortality. Feeding with breast milk was protective. Lack of effective antibiotics was the major challenge in treating these patients.

Author Biographies

Ajay Kumar, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital
Senior Specialist Department of Neonatology Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital New Delhi India
Valinderjeet Singh Randhawa, Lady Hardinge Medical College, New Delhi, India
Director Professor Department of Microbiology Lady Hardinge Medical College New Delhi India
Nilay Nirupam, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India

Senior Resident Department of Neonatology Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital New Delhi India

Yogita Rai, Lady Hardinge Medical College, New Delhi, India

Senior Resident Department of Microbiology Lady Hardinge Medical College New Delhi India

Arvind Saili, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India
Director Professor and Head Department of Neonatology Lady Hardinge Medical College and associated Kalawati Saran Children Hospital New Delhi India
Published
2014-08-13
How to Cite
1.
Kumar A, Randhawa VS, Nirupam N, Rai Y, Saili A (2014) Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India. J Infect Dev Ctries 8:1049-1054. doi: 10.3855/jidc.4248
Section
Brief Original Articles