Extensively Drug-Resistant Acinetobacter baumannii Complex (XDR-AB) Colonisation and Clinical Outcome in Neonates: A Retrospective Case-Control Study

Abstract

Extensively drug-resistant Acinetobacter baumannii (XDR-AB) is a significant cause of healthcare-associated infections, particularly in neonatal intensive care units (NICUs). This study aimed to determine the prevalence of XDR-AB colonisation and the odds of subsequent invasive infection. The secondary objective was to identify risk factors and in-hospital outcomes. We investigated 485 neonates admitted at Rahima Moosa Mother and Child Hospital from 1 June 2020 to 31 December 2022. Among them, 116 (23.92%) were colonised with XDR-AB, with a median colonisation age of 4 days. Of these, 29 (25%) developed invasive disease, and 12 (10.34%) died. Mechanical ventilation increased the risk of colonisation by 2.28 times. The study highlights the high prevalence of early colonisation and associated mortality, emphasizing the need for screening, vigilant monitoring, and tailored antibiotic treatment for colonized neonates