Male Gender and Severe Hypoxic Ischemic Encephalopathy—High-risk Factors for Carbapenem-resistant Acinetobacter baumannii: A Cohort Study in an Extramural NICU

ReseaRch aRticle7 babies were referred for perinatal asphyxia, and all of them had to be started on mechanical ventilation at admission.The two babies in whom the culture taken at admission isolated CRAB died within the first 48 hours of admission and rest seven babies had hospitalacquired CRAB sepsis.Details about the clinical features are given in Tables 1 and2. DiscussionIn our study spanning 12 months, 9 neonates had carbapenemresistant A. Baumannii sepsis, out of which 5 died, and 3 neonates introDuction Neonatal sepsis remains a leading cause of neonatal mortality, especially in extramural babies.Culture-positive sepsis was seen in 13.1% of the extramural babies in a study from India, and the case fatality rate in these babies was 23.4%. 1 Acinetobacter baumannii is emerging as a significant cause of sepsis in newborns, especially hospital-acquired sepsis. 1]3 We studied extramural babies admitted to our Neonatal Intensive Care Unit with carbapenem-resistant A. baumannii sepsis. Materials a n D MethoDsThe present study was a retrospective observational study, in which the case records of all newborns admitted to the NICU over a period of 1 year, from April 2018 to March 2019, who had carbapenem-resistant A. baumannii sepsis, were studied.A detailed evaluation of the records of all such babies was done with their birth history, treatment received, details of the hospital course, and the outcome.The study proposal was approved by the institute's ethics committee.Acinetobacter baumannii was considered carbapenemresistant (CRAB) if it was resistant to imipenem and/or meropenem.Carbapenem-sensitive A. baumannii (CSAB) was defined as an isolate that is sensitive to both imipenem and meropenem.Pan drug resistance was defined as resistance to all cephalosporins, carbapenems, aminoglycosides, quinolones, and colistin. resultsA total of 749 newborns were admitted to the NICU during the study period of 1 year, with a M: F of 1.8:1.Preterm babies constituted 23% of the total admissions.Out of 57 neonates who had culturepositive sepsis, A. baumannii was isolated in 13 (22%) babies; 9 (69.2%) of these babies had carbapenem-resistant A. baumannii sepsis.