Medicina Fluminensis, Vol. 59 No. 2, 2023.
Review article
https://doi.org/10.21860/medflum2023_300572
Acinetobacter Baumannii Pneumonia Associated with Mechanical Ventilation in COVID-19 Pandemic
Ivan Šitum
; KBC Zagreb, Klinika za anesteziologiju, reanimatologiju, intenzivno liječenje i terapiju boli, Zagreb, Hrvatska
Gloria Mamić
orcid.org/0000-0001-6505-3021
; KBC Zagreb, Klinika za anesteziologiju, reanimatologiju, intenzivno liječenje i terapiju boli, Zagreb, Hrvatska
Nikolina Džaja
; KBC Zagreb, Klinika za anesteziologiju, reanimatologiju, intenzivno liječenje i terapiju boli, Zagreb, Hrvatska
Lovro Hrvoić
; Sveučilište u Zagrebu, Medicinski fakultet Zagreb, Zagreb, Hrvatska
Daniel Lovrić
; KBC Zagreb, Klinika za bolesti srca i krvnih žila, Zagreb, Hrvatska
Marko Siroglavić
; KBC Zagreb, Klinički zavod za kliničku i molekularnu mikrobiologiju, Zagreb, Hrvatska
Ante Erceg
; KBC Zagreb, Klinika za anesteziologiju, reanimatologiju, intenzivno liječenje i terapiju boli, Zagreb, Hrvatska
Romana Perković
; KBC Zagreb, Klinika za neurologiju, Zagreb, Hrvatska
Slobodan Mihaljević
; KBC Zagreb, Klinika za anesteziologiju, reanimatologiju, intenzivno liječenje i terapiju boli, Zagreb, Hrvatska
Abstract
Infections caused by Acinetobacter baumannii are a major public health issue. Acinetobacter baumannii contaminates the hospital environment, skin, and mucous membranes of patients and is transmitted by the hands of staff, causing opportunistic infections such as pneumonia associated with mechanical ventilation, bacteremia, wound infections, and urinary tract infections. Ventilator-associated pneumonia is the second most common nosocomial infection in the intensive care units. The leading risk factor for the development of ventilator-associated pneumonia is invasive mechanical ventilation. In the patients with COVID-19 disease, the treatment in intensive care units often required intubation and the use of mechanical ventilation, exposing them to the risk of developing ventilator-associated pneumonia. Given the numerous overlaps in the clinical picture of COVID-19 pneumonia and ventilator-associated pneumonia, it is difficult to determine its prevalence with certainty. Lung damage caused by COVID-19, immunosuppressive therapy, frequent prophylactic use of antibiotics, and organizational difficulties (overcrowding in intensive care units, staff shortages, the need to protect staff from severe acute respiratory syndrome coronavirus 2 infection, etc.) have contributed to the increased incidence of ventilator-associated pneumonia in COVID-19 patients. Numerous mechanisms of antibiotic resistance and the increasing prevalence of multidrug-resistant strains such as carbapenem-resistant Acinetobacter baumannii present a challenge in treatment. In susceptible strains, monotherapy with carbapenems leads to a positive outcome. The treatment of carbapenem-resistant Acinetobacter baumannii strains in complicated infections is carried out mainly with colistin. Colistin can be administered intravenously or by inhalation, and it’s use in combination with other effective antibiotics is recommended.
Keywords
Acinetobacter baumannii; COVID-19; Pneumonia, Ventilator-Associated; Respiration, Artificial
Hrčak ID:
300572
URI
Publication date:
1.6.2023.
Visits: 1.563 *