Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 8 5 2016 12 19 288 297 EN Lida Shojaei Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mostafa Mohammadi Department of Intensive Care Unit, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad-Taghi Beigmohammadi Department of Intensive Care Unit, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mahsa Doomanlou Central Laboratory, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Alireza Abdollahi Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran Mohammad-Mehdi Feizabadi Department of Medical Microbiology, Tehran University of Medical Sciences, Tehran, Iran AND Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Hossein Khalili Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 2016 10 20 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.   https://ijm.tums.ac.ir/index.php/ijm/article/view/1171 https://ijm.tums.ac.ir/index.php/ijm/article/download/1171/664