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Hflp 3 Multidrug-resistant Acinetobacter Baumannii Infection H|| among Neonates in a Neonatal Intensive Care Unit at a H|| Medical Center in Central Taiwan
B| Hsiu-Mei Wei'. Yu-Lung Hsu'. Hsiao-Chuan Lin1-', His Tsung-Hsueh Hsieh'. Ting-Yu Yen'. Hung-Chih Lin~J. BJI Bai-Horng Su"J. Kao-Pin Hwang1"'
HI Division of Infectious Diseases. Children's Hospital, China H Medical University and China Medical University Hospital1, @Is Taichung, Taiwan; Division of Neonatology, Children's @s Hospital. China Medical University and China Medical HI University Hospital". Taichung. Taiwan; China Medical @H University College of Medicine3
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:| Background: Few studies have focused on multidrug-resistant [,' Acinetobacter baumannii (MDRAB) infection in neonates. The | aim of this study was to investigate risk factors for mortality in f neonates with MDRAB infection.
V Methods: This retrospective case-series study was conducted | at the Children's Hospital of China Medical University. @ Taichung. Taiwan. AJ1 patients hospitalized between January r 2010 and December 2013 in the neonatal intensive care unit I (NICU) with MDRAB infections were reviewed.
;. Results: A total of 67 isolates from 59 neonatal patients i were positive for MDRAB. Of the 67 isolates, 38 were from % blood (56.72%), 16 from sputum (23.88%), seven from pus \ 10.45%). three from ascites (4.48%), two from S cerebrospinal fluid (2.99%), and one from pleural fluid @@ (1.49%). There were five episodes of MDRAB clusters consisting of 28 cases during the study period. The \ ortality rate due to MDRAB sepsis was 20.34% (12/59). t The statistically significant risk factors for mortality due to ! MDRAB infection were being infected with MDRAB \ ithin 7 days of admission to the NICU, use of umbilical vein catheters, absolute neutrophil count < 1500/mm3, * platelet count < 100,000/mm3, and a delay in initiating > adequate antibiotic treatment.
\ onclusions: MDRAB infection is responsible for a high ; mortality rate among neonates in the NICU, especially in \ hose who have neutropenia or thrombocytopenia. Infection control and appropriateness of the initial antimicrobial agent s, with colistin play an important role in reducing mortality.
Risk-factor Analysis and Molecular Epidemiology of Respiratory Adenovirus Infection in Children in Taiwan, 2009-2013
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Jia-Lu Cheng. Fu-Yuan Huang, Nan-Chang Chiu, Hsin Chi MacKay Children's Hospital. Taipei, Taiwan
Background: Respiratory infections caused by human adenovimses (HAdV) of species B. C, and E (HAdV-B. -C,
-E) are worldwide. A significant increase of adenoviral infections is observed in Taiwan. We conducted this study to understand molecular epidemiology of respiratory HAdV and the risk factors of severe HAdV infections in Taiwanese children.
Methods: We collected pediatric cases of adenovirus infection hospitalized in a medical center in northern Taiwan between 2009 and 2013 to analyze their clinical characteristics and risk factors of severe adenovirus infection. The genotype of HAdV isolates were determined by sequencing the partial hexon and fiber genes. The nucleotide sequences were then compared by phylogenetic analysis.
Results: The 129 patients had a median age of 40.1 months (interquartile range 21.9-57.5 months) and included 74 boys and 55 girls. The 30 severe HAdV infections need ICU care. Of the viral isolates, 68 (52.7%) were HAdV-B. 35.7% as HAdV-C. and 10.1% as HAdV-E. including 59 (45.7%) with HAdV-3. 26 (20.2%) with HAdV-2. 13 (10.1%) with HAdV-4. 9 (7.0%) with HAdV-7, 6 (4.7%) with HAdV-5. 2 (1.6%) with HAdV-6. 12 (9.3%) with mixed and 2 (1.6%) untyped HAdV. Three major clades were identified with high bootstrap values including HAdV types B. E and C. In multivariate analysis, the risk factors for severe HAdV infection were serotype 7 (odds ratio (OR) 6.6, p = 0.029), cerebral palsy (OR 35.4. p < 0.001) and prematurity (OR 9.4, p = 0.006).
Conclusions: HAdV-3 is the most common serotype. Infected with HAdV-7. cerebral palsy and prematurity are risk factors of severe HAdV infections.
"| Q Characteristics of Pyogenic Osteomyelitis among Pediatric Patients in Southern Taiwan
Fu-Chun Kuo'. Shih-Min Wang2. Ching-Fen Shen1'3, Kai-Wen Wu1, Tzong-Shianii Ho2, Ching-Chuan Liu1'"' Departments of Pediatrics , Emergency Medicine" and Center for Infection Control"', College of Medicine, National Cheng Kung University and Hospital
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Background: Pyogenic osteomyelitis has become one of the most common invasive bacterial infections in children. Osteomyelitis is a severe infection of bone, occurring through hematogenous delivery, or direct inoculation. The clinical features depend on age and disease type and location. The aims of this study are to describe the epidemiological, clinical and microbiological features of pyogenic osteomyelitis in children during a period of 11 years.
Methods: Patients age < 18 year-old admitted and diagnosed as osteomyelitis at National Cheng Kung University Hospital f
rom 2004 to 2014 were enrolled. Pyogenic osteomyelitis was defined by clinical criteria together with one or more of the following: pus aspiration from bone, wound and joints: positive bacteria culture from specimens of blood, vim fluid, pus obtained directly of the involved bone: radicioacil abnormality. The clinical presentations, demographi: feature;, complications. microbiological information and an:ir:o::: rer_~un> were
