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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 24, No. 5, 2014, pp. 569-574
Bioline Code: pe14091
Full paper language: English
Document type: Research Article
Document available free of charge

Iranian Journal of Pediatrics, Vol. 24, No. 5, 2014, pp. 569-574

 en Risk Factors and Predictors of Mortality in Critically ill Children with Extensively-Drug Resistant Acinetobacter baumannii check for this species in other resources Infection in a Pediatric Intensive Care Unit
Kapoor, Kapil; Jain, Sumidha; Jajoo, Mamta; Dublish, Swati; Dabas, Vikas & Manchanda, Vikas

Abstract

Objective: Acinetobacter baumannii check for this species in other resources 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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