The Changes in Epidemiology of Imipenem-Resistant <i>Acinetobacter baumannii</i> Bacteremia in a Pediatric Intensive Care Unit for 17 Years
Dongsub Kim, Haejeong Lee, Joon‐sik Choi, Christina M. Croney, Ki-Sup Park, Hyo Jung Park, Joongbum Cho, Sohee Son, Jin Yeong Kim, Soo‐Han Choi, Hee Jae Huh, Kwan Soo Ko, Nam Yong Lee, Yae‐Jean Kim
Abstract
Background: Acinetobacter baumannii infections cause high morbidity and mortality in intensive care unit (ICU) patients. However, there are limited data on the changes of longterm epidemiology of imipenem resistance in A. baumannii bacteremia among pediatric ICU (PICU) patients. Methods: A retrospective review was performed on patients with A. baumannii bacteremia in PICU of a tertiary teaching hospital from 2000 to 2016. Antimicrobial susceptibility tests, multilocus sequence typing (MLST), and polymerase chain reaction for antimicrobial resistance genes were performed for available isolates. Results: A. baumannii bacteremia occurred in 27 patients; imipenem-sensitive A. baumannii (ISAB, n = 10, 37%) and imipenem-resistant A. baumannii (IRAB, n = 17, 63%). There was a clear shift in the antibiogram of A. baumannii during the study period. From 2000 to 2003, all isolates were ISAB (n = 6). From 2005 to 2008, both IRAB (n = 5) and ISAB (n = 4) were isolated. However, from 2009, all isolates were IRAB (n = 12). Ten isolates were available for additional test and confirmed as IRAB. MLST analysis showed that among 10 isolates, sequence type