Management Acinetobacter Baumanii Multi-Resistent Outbreak in PICU in 2 Cases Post-Liver Transplant

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Background: Acinetobacter baumanii (ABA) is an important pathogen with high mortality rates in pediatric intensive care units (PICUs) in Jakarta, occurred during January to February 2017 and was successfully controlled. Descriptive study of clinical characteristics infected cases with laboratoryexaminations and treatment during hospitalization. Case Presentation Summary : Two cases after liver transplant out of 11 cases hospitalized in PICU were infected by ABA which were resistant to all antibiotics except colistin and intermediate to tigecycline from the sputum and blood specimen. One of them had urin culture of ABA which was resistant to all antibiotics, but only sensitive to fosfomycin. First case is a boy 10 months-old, with Caroli disease who developed sepsis with paralytic bowel, thrombositopenia post-liver transplant, with leucocyte 19,290/µL, pro-calcitonin 24,6; C-reactive protein 60,8, length of stay (LOS) 34days. Second case is a boy 6 months-old, with bilier atresia who developed respiratory distress with pleural effusion and atelectasis post-liver transplant with leucocyte 19,210/µL, pro-calcitonin 30,29, C-reactive protein 80,3; LOS 34 days. Both patients were given immunosuppresive therapy tracolimus and methyl prednisolone. Meropenem combined with polimiksin B or fosfomycin were administered intravenously based on the culture results and they survived. To control outbreak, infected/colonized patients were isolated and measures were taken to prevent transmission. These measures comprised single use disposable gloves with maximal sterile barrier precautions, use of close system peripheral inserted central venous catheter (PICC), cleaning and disinfection of surfaces followed by deep clean of the liver transplant isolation room and room closed for 48 hours as control measure. Learning Points/Discussion : : Importance of strict re-enforcement of hygiene protocols was emphasized, with close-system PICC used in PICU. Without rapid detection from laboratory and hospital staff, the outbreak may resulted more deaths and great costs. This highlights the importance of well-trained professionals who adhere to good infection control program.
Original languageEnglish
Publication statusPublished - 2017
Event11th International Congress of Tropical Pediatric - ID, Yogyakarta, Indonesia
Duration: 1 Jan 2017 → …


Conference11th International Congress of Tropical Pediatric
Period1/01/17 → …


  • Acinetobacter, baumanii, PICU.


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