A COMPREHENSIVE STUDY OF ACINETOBACTER BAUMANNII IN VENTILATOR ASSOCIATED PNEUMONIA: A COGITATION CONCEPT

Background and Aim:Ventilator-associated pneumonia (VAP) due to a multidrug-resistant microorganism is a clinical concern. Acinetobacter baumannii is one of the appalling nosocomial organism featured by high antibiotic resistance and virulence capacity rendering the therapeutic modalities difficult. We aimed to characterize Acinetobacter baumannii isolated from mechanically ventilated patients in terms of epidemiological characteristics, antibiotic susceptibility, and presence of carbapenemase genes, sequence typing and their involvement in biofilm formation.Methods:Endotracheal secretions collected from 40 adults mechanically ventilated patients for bacterial culture. Antibiotic susceptibility was performed by disc diffusion test. Medical records were retrieved and analyzed to search out the risk factors of patient. Sequence group (SG) of isolates were identified by trilocus sequence-based typing (3LST). Presence of carbapenemase genes was assessed by PCR.Results:The incidence of VAP was 12.5% among patients on mechanical ventilation. The tracheostomy was found as an increased risk of VAP followed by a heart attack and chronic heart disease. A very high frequency of resistance was exhibited towards traditional antibiotics; none were resistant to colistin. Among all isolates, 55.9% belonged to SG1 and 8.8% to SG2 while others were grouped in novel epidemiological types. Oxacillinase genes showed their involvement in carbapenemase resistance. Presence of VIM and NDM was obvious in 26.2%, and 39.7% of isolates while 57.4% of them possessed bap gene.Conclusion:A. baumannii is a prevalent nosocomial pathogen, especially in patients who undergo mechanical ventilation. Finding risk factors and other characteristic features involved helps to discriminate real pathogen with commensal and opt accurate therapeutic agents.

کلیدواژه ها:

Acinetobacter baumannii ، Ventilator associated pneumonia ، Antibiotic resistance ، Biofilm