Acinetobacter junii causes life-threatening sepsis in preterm infants

Abstract

Acinetobacter junii caused sepsis in six preterm infants in our neonatal unit within 48 h. Each infant with clinical signs of systemic infection and activation of the acute phase response had two positive blood cultures with Acinetobacter junii. The sudden onset, the short duration of the outbreak and the fact that none of the infants were colonized by A. junii suggested a common source of A. junii administered directly into the blood. The only feature shared by all six affected newborns was an intravenous fat emulsion (Intralipid 10%), which was shown to be an excellent growth medium for A. junii. Sepsis did not occur in four infants with 20% fat emulsion or amino acids only. Vaminolact did not support growth of the outbreak strain. The immediate source of the outbreak could not be identified: samples of the actual feeds given were not available for investigation, but A. junii was not isolated from parenteral solutions with identical batch numbers used in the septic infants. We conclude that Acinetobacter junii can cause a life-threatening infection in preterm neonates. Contaminated intravenous fat emulsion is implicated as a possible source of the infection. As a part of rigid infection control, intravenous feedings should be prepared under aseptic conditions.

Carbapenem Resistance in Acinetobacter baumannii and Other Acinetobacter spp. Causing Neonatal Sepsis: Focus on NDM-1 and Its Linkage to ISAba125

“…Acinetobacter , a non-fermenting Gram-negative coccobacilli, has been noted as a pathogen in neonatal units in several parts of the globe and outbreaks caused by this organism have also been reported (Huang et al, 2002 ; Chan et al, 2007 ; Hammerum et al, 2015 ). Though A. baumannii has been predominantly implicated in neonatal infections or sepsis, “other species” within the genus have also been reported to have caused sepsis in neonates (Beaufort et al, 1999 ; Kilic et al, 2008 ). The ability of the species to acquire antibiotic resistance has now resulted in the acquisition of the potent carbapenem resistant gene, bla NDM−1 (Bonnin et al, 2012 ; Boulanger et al, 2012 ; Chuanfu et al, 2013 ).…”

A Case of Acinetobacter junii Cavitary Pneumonia With Bacteremia in a Patient With Systemic Lupus Erythematosus

“…A few reports of nosocomial outbreaks caused by A. junii have been described. The first study described an outbreak in a neonatal ICU and IV fat emulsion was implicated as the possible source [ 11 ]. The second study described the outbreak in Paediatric Oncology ward and aerators were implicated as the source [ 12 ].…”

“…Although A. junii is capable of causing serious infections, they are generally non-fatal because the micro-organism is commonly susceptible to antimicrobial agents. [ 11 ] Clinical presentation with septic shock within a week on A. junii infection has been described as an adverse prognostic factor.…”