Acinetobacter baumannii

Question

Dear ladies and gentlemen,
in the throat swab of our 7-year-old son Acinetobacter baumannii has been found. Acutally he receives cotrimoxazole due to an infection. Now we have been told, that we have to be isolated in the CF center and the weekly physiotherapy should take place from now on at home. Additionally, we would not have to take anything else into account. Now my question: next week our son should get gromments (tympanic tubes) on both sides as he has fluid behind the eardrum on both sides and hears 30% less. Is there anything special to consider due to the Acinetobacter baumannii? Is there an increased risk?
Furthermore we are registered for a cure...can this be done as planned?
Best regards,
S.M.

Answer

Hello,
you report, that Acinetobacter baumannii has been found in the throat swab of your 7-year-old son. The CF center, initiated then strict hygienic measures with separation from other patients as well as the performance of physiotherapy at home.
Furthermore you report, that your son is acutally treated with cotrimoxazole due to an infection.
You worry, as your son has a planned operation next week with the implantation of grommets on both sides. Furthermore you want to know, if the planned cure can take place as long as your son is infected with that germ.
To this special germ the German Robert-Koch institute has made a very detailed statement in its "epidemilogical bulletin" from the 12th August, 2013 (link to the German site: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2013/Ausgaben/32_13.pdf?__blob=publicationFile). Because of its partly very broad antibiotic resistance, this germ has to be taken very serious. As the infection of your child is known to you, you should urgently get in contac with the ENT doctor and discuss, which consequences have to be drawn from this infection.
Special emphazise has to be put in this context on the resistance pattern (antibiogram) of Acinetobacter baumannii. In case there is a broad resistance, I would postpone the planned implantation of grommets and try at first an eradication of the germ. At least, such an operation should only be performed under a preterm started antibiotic protection with colistin.
Because of the planned cure, you should also contact the rehabilitiaton clinic. Because of the high probability of transmission of the germ your child should indeed not take part in any rehabilitation measure as long as the germ is not eliminated for sure.
Is is very good that you have expressed your sorrows. Therefore a thorough planning of the medical care of your son can be realized.
We hope, that the germ of your son can be eliminiated very soon, so that no prolonged hygienic measures are necessary.
We wish you and your son much luck.

Best regards,
Dr. H.-G. Posselt

29.09.2014