Acinetobacter baumannii infection and colonization among pediatric patients in pediatric ICU and other ICUs

Introduction: The treatment of critically-ill children in pediatric intensive care units (PICUs) is associated with better outcomes, such as lower mortality rates. We compared the incidence of A. baumannii infection among pediatric patients treated only in PICUs with those treated in adult ICUs or multiple ICUs. Methods: We retrospectively reviewed the medical and laboratory records of 1041 critically-ill patients of the Department of Pediatrics aged under 18 years who were admitted to the ICUs of a tertiary referral hospital between May 2009 and June 2017. We investigated all kinds of specimens obtained after 48 hours of ICU admission to identify culture results positive for A.baumannii during ICU admission. Results: A total of 750 ICU admissions were included in this study, of whom 408 were treated only in the PICU (PICU group), and 342 were treated in the adult ICU or multiple ICU (AICU group). At the time of ICU admission, there were no significant differences between the PICU and AICU groups in gender and length of hospital stay. A. baumannii was isolated 14 times in the PICU group (3.4%) and 32 times in the AICU group (9.4%); thus, the incidence densities of positive culture results for A. baumannii were 1.77 and 3.65 per 1000 ICU-days, respectively. After multivariate analysis, PICU group had lower odds of positive culture results for A. baumannii compared with AICU group (adjusted odds ratio: 0.048, 95% CI: 0.242-0.995). Conclusions: Critically-ill children treated only at PICUs had a lower incidence of A. baumannii infection.