Case Report: Molecular Characterization of Bloodstream Infections due to Carbapenem-Resistant Acinetobacter baumannii: A Pediatric Case Series

José Iván Castillo Bejarano Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Monterrey, Mexico,

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Jorge Llaca Díaz Department of Clinical Pathology, Hospital Universitario “Dr. José Eleuterio González,” Francisco I. Madero Avenue, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Manuel Enrique de la O Cavazos Department of Pediatrics, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Hugo Sánchez Alanís Department of Clinical Pathology, Hospital Universitario “Dr. José Eleuterio González,” Francisco I. Madero Avenue, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Abiel Homero Mascareñas de los Santos Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Monterrey, Mexico,

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Fernando Espinosa Villaseñor Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Monterrey, Mexico,

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Rebeca Aguayo Samaniego Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Monterrey, Mexico,

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Daniel Siller Rodríguez Hospital Epidemiology and Surveillance Unit, Christus Muguerza Hospital Alta Especialidad, Monterrey, México

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Nestor Casillas Vega Department of Clinical Pathology, Hospital Universitario “Dr. José Eleuterio González,” Francisco I. Madero Avenue, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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ABSTRACT.

Acinetobacter baumannii poses a significant threat to public health due to the high rate of multidrug-resistant strains. However, information on the molecular characterization of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections in children is scarce. This study aimed to describe the molecular characterization of carbapenem-resistant A. baumannii infections in children from a hospital in Mexico. A retrospective study was conducted during the period 2017–2022. Clinical and demographic data were collected from the clinical records. Mass spectrometry was used for the identification of the strains. To confirm A. baumannii strains, a polymerase chain reaction (PCR) method was applied using a gyrB sequence. The carbapenemase-encoding resistance genes were detected by PCR. Six cases of CRAB were documented, including five in neonates. The median intensive care unit stay was 20 days, and all cases had an invasive medical device. Half of the patients had at least one medical condition. A high prevalence of coresistance was observed in most of the antibiotic groups. Three of the six strains coharbored carbapenemase genes: blaOXA-51, blaOXA-24, and blaIMP. Mortality was reported in two neonate patients. The present study shows a high rate of coharboring blaOXA-51, blaOXA-24, and blaIMP-1, which has a direct impact on therapeutic decisions. Implementation of antimicrobial stewardship programs is urgent to stop the spread of this microorganism.

Author Notes

Disclosure: Verbal informed consent was obtained from the patients’ parents to collect data from the clinical record.

Authors’ addresses: José Iván Castillo Bejarano, Abiel Homero Mascareñas de los Santos, Fernando Espinosa Villaseñor, and Rebeca Aguayo Samaniego, Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Monterrey, Mexico, E-mails: jicastillobejarano@gmail.com, a_mascarenas@hotmail.com, fernandoe2405@gmail.com, and rebesam97@gmail.com. Jorge Llaca Díaz, Hugo Sánchez Alanís, and Nestor Casillas Vega, Department of Clinical Pathology, Hospital Universitario “Dr. José Eleuterio González,” Francisco I. Madero Avenue, Universidad Autónoma de Nuevo León, Monterrey, Mexico, E-mails: jorgellaca@hotmail.com, has_inte@hotmail.com, and nestor.casillas.vega@hotmail.com. Manuel Enrique de la O Cavazos, Department of Pediatrics, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León, Monterrey, Mexico, E-mail: manuel.delaocvz@uanl.edu.mx. Daniel Siller Rodríguez, Hospital Epidemiology and Surveillance Unit, Christus Muguerza Hospital Alta Especialidad, Monterrey, México, E-mail: daniel.siller@christus.mx.

Address correspondence to Nestor Casillas-Vega, Department of Clinical Pathology, Hospital Universitario “Dr. José Eleuterio González,” Francisco I. Madero Avenue, Universidad Autónoma de Nuevo León, Monterrey, NL 64460 Mexico. E-mail: nestor.casillas.vega@hotmail.com
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