Clinical features, antimicrobial susceptibilities, treatment characteristics and outcomes of paediatric Acinetobacter lwoffii bacteremia: a case series.

Abstract

Purpose: This study aimed to evaluate the clinical characteristics, antibiotic susceptibilities, therapeutic approaches, and outcomes of paediatric patients with A. lwoffii bacteremia.

Methods: A case series was conducted of paediatric patients diagnosed with A. lwoffii bacteremia between September 2019 and December 2022. Demographic data, underlying diseases, sources of infection, antimicrobial susceptibility profiles, treatment modalities, and clinical outcomes were analysed.

Results: A total of 12 patients were included, with 58.3% female and a median age of 24 months (IQR: 11-58.5). Overall, 91.7% of isolates were susceptible to amikacin, 83.3% to ceftazidime, 83.3% to colistin, 66.6% to meropenem, 66.6% to piperacillin-tazobactam, and 100% to tigecycline. Three patients received combination antibiotic therapy and nine patients received monotherapy. Antibiotic lock therapy (ALT) was successfully applied in one patient with catheter-related bloodstream infection (CRBSI) whose central venous catheter (CVC) could not be removed. The median infection-related length of hospital stay was 10 days (IQR: 10-14 days). The median duration of bacteremia was 2 days (IQR: 2-3). No cases of persistent bacteremia, recurrence, or infection-related mortality were observed. Susceptibility-guided monotherapy or combination therapy resulted in favourable outcomes in all cases, underscoring the importance of pathogen-directed treatment.

Conclusion: Acinetobacter lwoffii remains an important pathogen of hospital-acquired bacteraemia in hospitalised children. Treatment with broad-spectrum beta-lactam antibiotics, either as monotherapy or combined with amikacin or colistin, appears effective.