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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 21, Issue 2, Pages 83-88
http://dx.doi.org/10.1155/2010/690715
Review

Systematic Review of Invasive Acinetobacter Infections in Children

Jia Hu and Joan L Robinson

Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

INTRODUCTION: Clinicians are generally familiar with Acinetobacter as an etiological agent for serious nosocomial infections in intensive care units. However, there are no previous reviews of the full spectrum of invasive infections in children.

METHODS: A systematic review of the literature was completed up to December 2008 for reports of invasive Acinetobacter infections in children.

RESULTS: There were 101 studies that met the inclusion criteria including 18 possible outbreaks, 33 case series and 49 case reports. Suspected outbreaks were concentrated in neonatal intensive care units (16 of 18 outbreaks) and involved bacteremia or meningitis. Proof of isolate clonality or identification of the source of the outbreak was seldom established. Case series were primarily of children younger than five years of age presenting with bacteremia (sometimes multiresistant), meningitis, endocarditis or endophthalmitis, with many community-acquired infections being reported from India. Case reports consisted of unique presentations of disease or the use of novel therapies. Attributable mortality in the outbreaks and case series combined was 68 of 469 (14.5%).

DISCUSSION: Invasive Acinetobacter infections in children usually manifest as bacteremia, meningitis or both, but can result in a wide variety of clinical presentations. Outbreaks are primarily a problem in newborns with underlying medical conditions. Most reports of community-acquired infections are from tropical countries. The study of the mechanism of colonization and infection of children in intensive care units and of neonates in tropical countries may provide some insight into prevention of invasive infections.