We have a baby diagnosed at birth with tracheo-esophagela atresia and was operated on the second day of life. Post-op, patient started deteriorating with respiratory failure, needing inotropic support with mottled skin, and was clinically septic. Blood culture was taken that day and grew acinetobacter spp. resistant to all antibiotics tested (3rd gen cephalosphorins, ciprofloxacin, tienam, meropenem, aminoglycosides, ticarcillin). Though we have started the patient already on Tienam and Vancomycin prior to this culture result. Then on we changed vancomycin to amikacin..but repeat culture still showed the same organism. The ICD tube inserted by the surgeon post-op was draining serous fluid and we've sent that for culture and gram staining, and it grew the same organism... discussion was made to remove the tube but he refused.

If anyone has any experience with this kind of sepsis, we need help for antibiotic coverage

Rifampin and TMP/SMZ have some degree of effectiveness against Acinetobacter, but these are not usually plated. Could your lab check sensitivities to these drugs?

Mitchell Goldstein, M.D.

We have done sensitivities to these 2 drugs but came resistant as well. Patient had expired 2 days back.

It appears from this article that tigecycline/Tygacil has been found effective against MDR Acinetobacter strains. I am not sure if this new drug is available where you are located. I have only seen one case of acinetobacter in my unit, and it was sensitive to cefotaxime/vancomycin.

http://www.medpagetoday.com/InfectiousDisease/2005ICAACMeeting/tb/4214

Please check senstivities to Tazobactam, ciprofloxacin

hİ ,

sometimes I wonder that what happens to those babys , so İf we send any feedback to each other about outcomes it would be more helpfull.

have nice days..

We had some acinebacter sepsis in our unit.

Once it was sensitive to piperacillin/tazobactum.

On another occasion it was sensitive to meropenem.

Fortunately I have not come across such a resistant organism as described by "reginamanlulu".

Can others also share their sensitive patterns of acinetobacter so as to add to this pool of knowledge. You may never know, that the knowledge you share may actually save some baby's life one day.