Carbapenem-Resistant Acinetobacter baumannii Infection in Children From a Third-Level Hospital in Mexico: Clinical Characteristics and Molecular Epidemiology

Abstract

Abstract Background Acinetobacter baumannii has emerged as a threat to public health due to the high prevalence of multidrug-resistant isolates. Information regarding the clinical and molecular characterization of carbapenem-resistant A. baumannii (CRAB) infections in children is scarce. Our study aimed to describe the clinical and molecular characteristics of CRAB infections in children from a third-level center in Mexico. Methods Consecutive cases of CRAB infections were documented during 2017–2022. Clinical and demographic data were collected from clinical records. Mass spectrometry was used for the identification of the isolates. The identification of A. baumannii strains was confirmed by conducting a polymerase chain reaction (PCR) assay targeting the gyrB sequence. In addition, the carbapenemase-encoding resistance genes were detected by PCR. Results Twenty-one cases of CRAB infections were documented: 76% female and 62% were neonates. The median hospital length of stay at the time of positive culture was 37 days (interquartile range, 13–54). Sixty-four percent of the isolates were recovered from bronchial secretions. A co-resistance rate greater than 60% was observed for most groups of antibiotics. All carbapenem-resistant isolates carried blaOXA-24 genes. BlaIMP genes were detected in half of the cases, with all strains co-harboring blaOXA-24 genes. Conclusions The present study demonstrated a high proportion of CRAB infections in the neonatal population, a high prevalence of co-resistance to antibiotics, and a high rate of isolates carrying blaOXA-24 and blaIMP genes. CRAB is a significant concern due to the mortality rate and the lack of therapeutic alternatives; implementing infection prevention and control programs is urgent to stop the spread of carbapenem-resistant A. baumannii.