Risk factors and antibiotic resistance analysis of pneumonia caused by multidrug resistant acinetobacter baumannii in pediatric intensive care unit

Abstract

Objective To investigate the risk factors involved in the refractory pneumonia caused by multidrug resistant acinetobacter baumannii (MDRAb) in pediatric Intensive care unit (PICU).Methods From January 2009 to August 2011,115 patients with MDRAb pneumonia were treated in Department of Emergency,Wuhan Children's Hospital,Wuhan.Another 45 patients with negative MDRAb (NMDRAb)pneumonia served as control.The patients in the two goups were analyzed using univariate and multivariate Logistic regression to find out the risk factors for MDRAb infection.Results Among the 176 clinical strains of acinetobacter baumannii isolated,128 (72.73％) strains were MDRAb.After drug susceptibility tests,acinetobacter baumannii showed the rates of resistance to β-lactams antibiotics not including cefoperazone-sulbactam were more than 70％,and the rates of resistance to carbapenems antibiotics were higher than 90％.All rates of resistance to antibiotics of betalactams and carbapenems in MDRAb were higher than those in NMDRAb significantly.There were very low rates of drug-resistance found in Amikacin,Levofloxacin,Ciprofloxacin and Minocycline ( ＜20％ ).Multivariate logistic regression revealed that ICU stay,length of time for mechanical ventilation,anemia,hypoproteinemia and the use of carbapenems were independent risk factors involved in MDRAb pneumonia.Conclusions MDRAb was an important conditional pathogen with high rate of drug-resistance to many antibiotics leading to pneumonia in PICU.It increased the mortality of patients significantly.To control the infection of MDRAb was the key to increasing efficacy of treatment of pneumonia in PCIU. Key words: Pediatric; Intensive care unit; Multidrug resistant; Acinetobacter baumannii; Pneumonia; Risk factor; Retrospective study