Community Acquired Acinetobacter Baumannii in Pediatric Patients Under 1 Year Old With a Clinical Diagnosis of Whooping Cough in Lima, Peru

Abstract

Purpose: Acute respiratory infections (ARIs) continue to be the leading cause of child mortality in Peru. Data on the epidemiology of Acinetobacter baumannii and its role in respiratory infection among pediatric patients is still scarce. This study aimed to determine the prevalence of A. baumannii in children aged less than one year hospitalized with a clinical diagnosis of whooping cough. Methods & Materials: A prospective cross-sectional study was conducted in five hospitals in Lima, Peru. Patients under 1 year old admitted with a clinical diagnosis of whooping cough were included in the study. Nasopharyngeal samples were obtained from each patient upon admission and the presence of A. baumanii was determined using a polymerase chain reaction (PCR) assay for the detection of the OXA-51 gene. Also co-infections with other respiratory pathogens was evaluated by molecular methods, including Bordetella pertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae, Influenza A and B and Adenovirus. Results: A total of 225 nasopharyngeal samples were studied. The presence of A. baumanii was detected in 20.89% (47/225) of the nasopharyngeal swab samples. The samples were obtained upon admission to the hospital, therefore, infection by A. baumanii may have occurred in the community. Among the 47 patients with A. baumanii: 5 were diagnosed with A. baumanii monoinfection, 17 co-infection with bacteria, 7 co-infection with virus and 18 co-infection with bacteria + virus. It was observed that children between 29 days and 3 months old had the highest prevalence with 53.3%. The most common co-infecting pathogens were Bordetella pertussis in 55.3%, Adenovirus in 42.6% and Mycoplasma pneumoniae in 23.4%. Conclusion: In conclusion, this is the first report describing the presence of community-acquired A. baumannii in nasopharyngeal samples of children under 1 year old with whooping cough. Co-detection with multiple pathogens is frequent, with up to 6 respiratory infectious agents at the same time, being A. baumannii and B. pertussis co-infection the most prevalent. Further studies are required to determine the role of A. baumannii infections in acute respiratory infections in young children, particularly in those with non-critical disease and outside of intensive care units.