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Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients

BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in cr...

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Autores principales: Shojaei, Lida, Mohammadi, Mostafa, Beigmohammadi, Mohammad-Taghi, Doomanlou, Mahsa, Abdollahi, Alireza, Feizabadi, Mohammad Mehdi, Khalili, Hossein
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5277596/
https://www.ncbi.nlm.nih.gov/pubmed/28149487
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author Shojaei, Lida
Mohammadi, Mostafa
Beigmohammadi, Mohammad-Taghi
Doomanlou, Mahsa
Abdollahi, Alireza
Feizabadi, Mohammad Mehdi
Khalili, Hossein
author_facet Shojaei, Lida
Mohammadi, Mostafa
Beigmohammadi, Mohammad-Taghi
Doomanlou, Mahsa
Abdollahi, Alireza
Feizabadi, Mohammad Mehdi
Khalili, Hossein
author_sort Shojaei, Lida
collection PubMed
description BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in critically ill patients. MATERIALS AND METHODS: In this prospective study, 29 patients with carbapenem resistance A. baumannii ventilator-associated pneumonia were enrolled. Endotracheal aspirate specimens were analyzed according to the clinical and laboratory standard institute instructions in the hospital’s microbiology laboratory. Demographics, clinical, microbiological and laboratory findings were collected for each patient during the treatment course. Therapeutic empirical regimen, change in antibiotic regimen following receiving antibiogram results, clinical and microbiological responses, duration of ICU stay and outcome were collected for each recruited individual. RESULTS: All of A. baumanii isolates were resistant to pipracillin-tazobactam, ceftriaxon, amikacin and ciprofloxacin. The resistance rate of A. baumanii species was 41.4% for ampicillin/sulbactabm and 93.1% for meropenem. Patients received either meropenem/colistin (51.7%) or meropenem/ampicillin-sulbactam (48.3%) as the treatment regimens based on the antimicrobial susceptibility patterns of isolates. Ventilator-associated pneumonia clinical response, improvement and failure achieved in 15 (51.7%), 8 (27.6%) and 6 (20.7%) of the patients respectively. Microbiological eradication and intermediate status were observed in 9/29 (31%) and 11/29 (37.9%) of patients, respectively CONCLUSION: The antibiotic regimens showed comparable efficacy in treatment of VAP due to MDR A. baumannii but mortality rate was high. Considering widespread and high mortality rates associated with MDR infections, applying infection control and antibiotic stewardship programs in hospitals are essential.
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spelling pubmed-52775962017-02-01 Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients Shojaei, Lida Mohammadi, Mostafa Beigmohammadi, Mohammad-Taghi Doomanlou, Mahsa Abdollahi, Alireza Feizabadi, Mohammad Mehdi Khalili, Hossein Iran J Microbiol Original Article BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in critically ill patients. MATERIALS AND METHODS: In this prospective study, 29 patients with carbapenem resistance A. baumannii ventilator-associated pneumonia were enrolled. Endotracheal aspirate specimens were analyzed according to the clinical and laboratory standard institute instructions in the hospital’s microbiology laboratory. Demographics, clinical, microbiological and laboratory findings were collected for each patient during the treatment course. Therapeutic empirical regimen, change in antibiotic regimen following receiving antibiogram results, clinical and microbiological responses, duration of ICU stay and outcome were collected for each recruited individual. RESULTS: All of A. baumanii isolates were resistant to pipracillin-tazobactam, ceftriaxon, amikacin and ciprofloxacin. The resistance rate of A. baumanii species was 41.4% for ampicillin/sulbactabm and 93.1% for meropenem. Patients received either meropenem/colistin (51.7%) or meropenem/ampicillin-sulbactam (48.3%) as the treatment regimens based on the antimicrobial susceptibility patterns of isolates. Ventilator-associated pneumonia clinical response, improvement and failure achieved in 15 (51.7%), 8 (27.6%) and 6 (20.7%) of the patients respectively. Microbiological eradication and intermediate status were observed in 9/29 (31%) and 11/29 (37.9%) of patients, respectively CONCLUSION: The antibiotic regimens showed comparable efficacy in treatment of VAP due to MDR A. baumannii but mortality rate was high. Considering widespread and high mortality rates associated with MDR infections, applying infection control and antibiotic stewardship programs in hospitals are essential. Tehran University of Medical Sciences 2016-10 /pmc/articles/PMC5277596/ /pubmed/28149487 Text en Copyright© 2016 Iranian Neuroscience Society This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.
spellingShingle Original Article
Shojaei, Lida
Mohammadi, Mostafa
Beigmohammadi, Mohammad-Taghi
Doomanlou, Mahsa
Abdollahi, Alireza
Feizabadi, Mohammad Mehdi
Khalili, Hossein
Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients
title Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients
title_full Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients
title_fullStr Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients
title_full_unstemmed Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients
title_short Clinical response and outcome of pneumonia due to multi-drug resistant Acinetobacter baumannii in critically ill patients
title_sort clinical response and outcome of pneumonia due to multi-drug resistant acinetobacter baumannii in critically ill patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5277596/
https://www.ncbi.nlm.nih.gov/pubmed/28149487
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