Prevalence incidence and clinical outcome of Klebsiella and Acinetobacter ventilator-associated pneumonia

Abstract

Introduction: Antimicrobial resistance identification for each hospital has benefits in management of nosocomial infections. Objectives: The aim of this study was to determine antimicrobial susceptibility of meropenem against Acinetobacter and Klebsiella strains in samples obtained from hospitalized patients with ventilator-associated pneumonia (VAP). Patients and Methods: In this cross-sectional study, 100 patients with VAP were selected from the intensive care unit (ICU) of Amin hospital in Isfahan. Lung secretions were collected and tested for bacterial infections. In samples with the positive bacterial infection, E-test and agar diffusion test were used to determine and compare the susceptibility of Acinetobacter and Klebsiella strains to meropenem. Results: The two susceptibility testing methods – E-test and agar diffusion test – showed similar results in 87 cases (87%) therefore, 84 cases were resistant and three cases were susceptible to meropenem. However, in 13 cases, the result of the agar diffusion test was resistant and the result of E-test was sensitive. According to the Kappa test, the agreement between the two tests was 0.87 and statistically significant (P <0.001). Conclusion: Due to the high resistance of Klebsiella and Acinetobacter strains to meropenem, it should not be used as an experimental treatment in patients diagnosed with VAP caused by these strains. We recommend using meropenem for Acinetobacter and Klebsiella after susceptibility testing by E-test confirmed its efficacy.