Revisão bibliográfica : pneumonias associadas à ventilação mecânica (PAV) por Acinetobacter baumannii multidrogaresistentes

Abstract

Ventilator-associated pneumonia (VAP) is a more frequent nosocomial infection in an intensive care unit (ICU) that may occur after 48/72 hours of endotracheal intubation and invasive mechanical ventilation, the objective of this literature review was to describe the mechanisms Of resistance most commonly found in Acinetobacter baumannii in ICU patients, describing the profile of antimicrobial resistance by this microorganism, evaluating the main risk factors for acquisition of VAP, correlating with risk factors for multidrug-resistant agents. Considering that Acinetobacter baumannii was initially not considered to be a virulent pathogen and it was not able to cause outbreaks in hospitals, it has been verified that over the years this microorganism has acquired a mechanism of resistance to a diversity of antimicrobials, besides virulence factors capable of degrading the Classes of antimicrobial of last choice, being classified as multidrug resistant bacteria strains that are resistant to three or more classes of antibiotics, sensitive to polymyxin and variable susceptibility to ampicillin + sulbactam and pan-resistant ones that have acquired resistance to all classes. During this study high was found levels of resistance to most antimicrobials, clinically available for the treatment of infections by A. baumannii; among isolates resistant to imipenem, all they were multidrug-resistant, resistant to at least five of the seven groups of antimicrobial agents tested. In most cases polymyxin B and tigecycline were the only tested antibiotics that have demonstrated efficacy against A. baumannii, however some studies reported the existence of strains resistant to these classes.