Introduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is being increasingly observed and is associated with significant morbidity and mortality in newborns. In this study, we determined the epidemiology, risk factors, and outcomes of blood stream infection (BSI) caused by CRAB in neonates. Methodology: The clinical charts of neonates who developed Acinetobacter baumannii BSI in the period between 1 January 2010 and 31 December 2012 were reviewed. Results: During the study period, 65 neonates developed Acinetobacter baumannii BSI; 33 were CRAB at an incidence of 0.50 case per 1,000 patient-days. Compared with carbapenem-sensitive Acinetobacter baumannii (CSAB), patients with CRAB BSI had significantly higher prior antimicrobial use, longer duration of ventilation, and late isolation of organisms. Feeding with expressed breast milk was protective. All isolates of Acinetobacter baumenii were sensitive to colistin and tigecycline. The all-cause mortality rates were 27.3% in CRAB and 9.4% in CSAB BSI, respectively (p = 0.074). Conclusions: Neonatal BSI caused by CRAB was not common but caused high mortality. Feeding with breast milk was protective. Lack of effective antibiotics was the major challenge in treating these patients.

The authors report a case of 13-y-old boy who presented with pain in bilateral knee and ankle joints accompanied by petechiae all over the body and hematochezia. On investigation, he had pancytopenia, which on subsequent evaluation revealed aplastic anemia. On investigation for short stature, he was diagnosed as a case of celiac disease. He was started on gluten free diet and the counts improved over 8 mo. Association between aplastic anemia and celiac disease has rarely been reported. To the best of authors' knowledge only 8 adult cases of celiac disease associated with aplastic anemia have been published. This is the first report to suggest an association in children and response to a gluten free diet.

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