Background and Aim Acinetobacter baumannii has become an important cause of nosocomial infection, but little is known about its impact on the neonatal intensive care unit (NICU). We planned to characterize the clinical manifestations and outcomes of patients with A. baumannii bacteremia in the NICU.

Methods All patients with A. baumannii bacteremia in our NICU from 2003–2010 were reviewed. A matched case-control study was performed by comparing each case of A. baumannii to 2 uninfected controls and all cases of Escherichia coli and Klebsiella bacteremia, respectively.

Results 37 sporadic cases of A. baumannii bacteremia were identified. Pan-drug resistant isolate was noted in only 2 cases (5.4%), and the overall mortality rate was 8.1%. Infants with A. baumannii bacteremia had median gestational age and birth weight of 28 weeks and 1090 grams, respectively. Compared to matched, uninfected controls, infants with A. baumannii were more likely to have had a central vascular catheter (CVC) (OR=3.78; 95%CI: 1.44 to 12.35) and longer duration of ventilator use and hospitalization (both P<0.001). Compared to E coli or Klebsiella bacteremia, infants with A. baumannii bacteremia had lower birth weight (median of 1090gms vs 1300gms, P=0.044) and a higher rate of CVC and TPN use (both P<0.001) at the time of infection.

Conclusions A. baumannii bacteremia occurs sporadically in the NICU, primarily in low birth weight infants on TPN use and with CVC in situ. Although A. baumannii does not often cause mortality and PDR- A. baumannii is uncommon, it contributes significantly to longer hospitalization.