Risk Factors and Predictors of Mortality in Critically ill Children with Extensively-Drug Resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit

Kapil  Kapoor; Sumidha  Jain; Mamta  Jajoo; Swati  Dublish; Vikas  Dabas; Vikas  Manchanda

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Risk Factors and Predictors of Mortality in Critically ill Children with Extensively-Drug Resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit

Author(s):

Kapil Kapoor^1,*,

Sumidha Jain²,

Mamta Jajoo³,

Swati Dublish⁴,

Vikas Dabas⁵,

Vikas Manchanda⁶

IJ Pediatrics:Vol. 24, issue 5; 569-574

Published online:Sep 11, 2014

Article type:Research Article

Received:Oct 30, 2013

Accepted:May 05, 2014

How to Cite:Kapil KapoorSumidha JainMamta JajooSwati DublishVikas DabasVikas Manchandaet al.Risk Factors and Predictors of Mortality in Critically ill Children with Extensively-Drug Resistant Acinetobacter baumannii Infection in a Pediatric Intensive Care Unit.Iran J Pediatr.24(5):569-574.

Abstract

Objective: Acinetobacter baumannii is an important emerging cause for extensively-drug resistant (XDR) hospital associated infections (HAIs) in pediatric intensive care units (PICU). The study was done to evaluate the risk factors, outcome, antibiotic sensitivity pattern, and predictors of mortality in critically ill children with XDR A. baumannii infection. Methods: Retrospective case control study, done in the PICU of a tertiary care pediatric hospital of India from April 2010 to March 2012. Findings: Eighty-five children who developed XDR A. baumannii infection matched to 170 controls. Majority (76%) of the organisms were isolated from endotracheal lavage. The mortality rate was 28.2% (24/85). The factors found to be significantly associated with A. baumannii infection were prior use of broad-spectrum antibiotics, major surgeries done, prolonged PICU stay, use of central venous catheters, and mechanical ventilation. The predictors of mortality associated with A. baumannii infection were acute kidney injury, presence of septic shock, and disseminated intravascular coagulopathy. Colistin found to be the single most effective drug against XDR A. baumannii infection. Conclusion: XDR A. baumannii infections are associated with high morbidity and mortality in critically ill children. Early diagnosis and treatment are crucial. Implementation of infection control practices and rational use of antibiotics are required to control such infections.

Keywords

Acinetobacter Baumannii

Extensively-Drug Resistant

Hospital Associated Infection

Children

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