Acinetobacter baumannii: A Rare Organism Causing Blood Stream Infection in a Five-Year Old Girl in South-East Nigeria

Abstract

Aim: Acinetobacter baumannii is an aerobic Gram-negative coccobacilli found in the environment, which causes predominantly nosocomial infections in humans. However, the incidence of community acquired infections is on the increase. It is characterized high resistance to the environment and the ability to develop resistance to commonly prescribed antimicrobials.  Its clinical features are non-specific and range from a benign transient bacteremia to fulminant septic shock. Carbapenems are recommended for first line treatment. This series presentation aims to increase awareness of this condition. Presentation of Cases: A case of a five-year old girl who presented with features suggestive of an upper respiratory tract infection in Enugu State, South-East Nigeria is reported. She also had a history of recent travel to Europe. Serial haematologic investigations showed evidence of worsening bacteremia and blood culture revealed Acinetobacter baumannii. She was managed with intravenous Meroponem and was discharged sixteen days after presentation. Discussion: In this case, the finding of Acinetobacter baumannii from blood culture followed an initial non response to conventional antibiotics and the history of recent travel to Europe. This organism has hitherto not been isolated in our environment, and is a significant cause of nosocomial infections with high morbidity and mortality. Isolation of this organism requires BACTEC culture methods. Its high resilience and multidrug resistance makes it difficult to treat. Conclusion: The incidence of community acquired Acinetobacter baumannii is on the increase. Management involves a high index of suspicion, prompt and accurate isolation of infecting strains and the proper choice of antibiotic regimens.