Acinetobacter baumannii Infection in the Neonatal Intensive Care Unit

Abstract

Background: To perform a prospective case control study of blood stream infection to determine the infection rate of Acine­tobac­ter baumannii and the risk factors associated with mortality.
Methods:   From February 2004 to January 2005, 579 consecutive episodes of blood stream infection were obtained at two neo­na­tal intensive care units Al Nasser and Al Shifa hospitals in Gaza City. Forty (6.9%) isolates of A. baumannii were ob­tained from the neonates under 28 d. Most of the isolates (92%) were from hospitalized patients in the intensive care units.
Results: Community acquired infection was 8%.  Sixty three percent of the patients were males. The isolates of A. bauman­nii were resistant to commonly used antibiotics while being sensitive to meropenem (92.5%), imipenem (90%), chloram­pheni­col (80%), ciprofloxacin (75%), gentamicin (57.5%), ceftriaxone (50%), amikacin (37.5%), cefuroxime and ce­fo­taxime (35%). Over all crude mortality rate was 20% with much higher crude mortality among patients with noso­co­mial infec­tion.  Based on logistic regression, the following factors were statistically significant: weight < 1500g, age < 7 d, mean of hospitalization equal 20 days, antibiotic use, and mechanical ventilation, when compared to the control group (P< 0.05).
Conclusion:  Infection rate of nosocomial blood stream infection was considerable and alarming in neonatal intensive care unit infants and associated with a significant excess length of NICU stay and a significant economic burden.