P-824. A Tertiary Care Hospital's Eight-Year Experience with Acinetobacter Bloodstream Infections in the Pediatric Population

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Abstract Background Acinetobacter spp has emerged as an important nosocomial pathogen causing life-threatening infections in hospitalized patients. Since carbapenem-resistant Acinetobacter bloodstream infections have been increasingly reported in the pediatric population worldwide in recent years, we aimed to evaluate the clinical characteristics and identify possible risk factors in hospitalized patients with carbapenem-resistant bloodstream infections. Methods We retrospectively analyzed the results of blood-stream infections caused by Acinetobacter spp. in hospitalized children between 2014-2022. Demographic features and clinical and laboratory findings were evaluated. Results Bloodstream infections due to Acinetobacter spp. were detected in 70 hospitalized children. Carbapenem resistance was present in 38 (54.2%) of the patients. The mean age of patients with carbapenem-resistant (CR) Acinetobacter bloodstream infection (21 males and 17 females) was 5.7±0.95 years and 3.9±0.74 years in the carbapenem-susceptible (CS) group (13 males and 19 females) (p< 0.005). The most common pathogen in the CR group (97.4%) and CS group (56.3%) was Acinetobacter baumannii. While 15.3% of the CR patients were previously healthy, 3.1% of the CS group had no history of previous diseases. The most important predisposing risk factors for the development of carbapenem resistance were invasive mechanical ventilation (p< 0.005), previous antibiotic use (p< 0.005), and history of meropenem use (p< 0.005). Combination therapy was initiated in 64.6% of patients in the CR group and 53.1% in the CS group. The most frequently used antibiotic regimens in the CR group were meropenem-colistin (15.8%), colistin-amikacin (10.5%), and colistin-sulfamethoxazole and trimethoprim (SMZ-TMP) (7.9%). The mean treatment duration for the groups was 13.3±0.98 days for the CR group and 11.3±1 days for the CS group (p:0.523). The infection-related mortality rates for the CR and the CS groups were 36.8% and 21.9%, respectively, and there was no statistically significant difference between the groups (p:0.136). Conclusion Our single-center experience aims to emphasize the importance of rational antibiotic use and enhance the awareness of clinicians about the increasing carbapenem resistance. Disclosures All Authors: No reported disclosures

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