[Acinetobacter baumannii: an important pathogen with multidrug resistance in newborns]
Istemi Han Celik1, Gamze Demirel, Hatice Tatar Aksoy
1Zekai Tahir Burak Maternity Teaching Hospital, Department of Neonatology, Ankara, Turkey. istemihancelik@gmail.com
Mikrobiyoloji Bulteni
|November 18, 2011
Summary
Multidrug-resistant Acinetobacter baumannii causes severe infections in premature infants, leading to high mortality. Limiting invasive procedures and improving infection control are crucial for preventing Acinetobacter infections in neonatal intensive care units.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Nosocomial sepsis in premature infants is a significant cause of morbidity and mortality.
- Acinetobacter baumannii has emerged as a leading pathogen in neonatal intensive care units, often exhibiting multidrug resistance.
Purpose of the Study:
- To retrospectively evaluate the demographic, clinical, microbiological characteristics, and risk factors of Acinetobacter baumannii infections in premature infants.
- To identify effective antibiotic treatments and inform infection control strategies.
Main Methods:
- Retrospective analysis of 21 premature infants with Acinetobacter baumannii infection hospitalized between January 2010 and February 2011.
- Identification of isolates using conventional methods and antibiotic susceptibility testing via Vitek 2 Compact system.
- Data collection on patient demographics, clinical presentation, risk factors, and treatment outcomes.
Main Results:
- Acinetobacter baumannii was isolated from various sites, including blood, central venous catheters, CSF, tracheal aspirates, and urine.
- Key risk factors included mechanical ventilation (95%), prematurity (91%), total parenteral nutrition (81%), and central catheter use (67%).
- High rates of multidrug resistance were observed (95%). Gentamicin and amikacin showed the highest susceptibility rates.
Conclusions:
- Acinetobacter baumannii is an increasing threat in neonatal intensive care units, characterized by multidrug resistance and significant mortality in premature infants.
- Controlling Acinetobacter infections requires limiting invasive procedures, total parenteral nutrition, and broad-spectrum antibiotics, alongside strict isolation and infection control measures.
- Special attention is needed for low-birth weight infants due to their heightened susceptibility.
Related Concept Videos
01:25Mechanism of Antibiotic Resistance in MRSA
Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
01:25Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
01:30Development of Antibiotic Resistance
Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...