ANTIMICROBIAL RESISTANCE PATTERNS AND TREATMENT OUTCOMES OF VENTILATOR-ASSOCIATED PNEUMONIA CAUSED BY ACINETOBACTER BAUMANNII IN PATIENTS WITH STROKE
Main Article Content
Abstract
Background: Ventilator-associated pneumonia is a common infectious complication in patients with stroke requiring respiratory support. Multidrug-resistant Acinetobacter baumannii is an important pathogen associated with high rates of treatment failure and mortality. Objectives: To investigate the clinical characteristics, laboratory findings, antimicrobial resistance patterns, predictors of mortality, and treatment outcomes in patients with stroke and ventilator-associated pneumonia caused by Acinetobacter baumannii. Materials and methods: A prospective study was conducted in 89 patients with stroke (either previously diagnosed or newly diagnosed) who developed ventilator-associated pneumonia caused by Acinetobacter baumannii and were treated at Can Tho Central General Hospital from July 2024 to May 2026. Results: Among the 89 patients, the mean age was 67.8 years; hypertension was present in 82.0% of patients, and early-onset ventilator-associated pneumonia accounted for 75.3% of cases. Acinetobacter baumannii was resistant to most antimicrobial agents, except for colistin, with a resistance rate of 1.8%. Older age, a history of intravenous antibiotic use within the previous 90 days, renal replacement therapy, and failure to respond to empiric antibiotic therapy were identified as independent predictors of mortality. The 30-day mortality rate was 42.7%. Conclusion: Ventilator-associated pneumonia caused by Acinetobacter baumannii in patients with stroke is associated with high rates of antimicrobial resistance and mortality. Colistin remains effective against the majority of isolates. Factors related to epidemiological characteristics, prior antibiotic exposure, and response to initial empiric antibiotic therapy have a significant impact on the risk of mortality and should be identified early to optimize treatment.
Keywords
Ventilator-associated pneumonia, acute stroke, Acinetobacter baumannii
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