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A 80-year-old male presented with acute shoness of breath. His SpO2 levels were 80%. He was immediately intubated and shifted to the ICU and put on the ventilator. He was a chronic smoker and a known case of COPD for the past 5 years. He was staed in empirical antibiotics. Initial culture tests were negative. After 9 days, he developed ceain lesions in the lungs along with high grade fever. A bronchoalveolar lavage was done and sent for gram staining. The organism isolated was a multi-drug resistant organism. Biochemical reactions revealed oxidase positive and did not ferment any sugars. The organism isolated is resistant to all antibiotics except: -

A
Colistin
B
Amoxicillin
C
Azithromycin
D
Amikacin
High-Yield Explanation
This is a case of Acinetobacter baumanii. X-ray shows consolidation patches in both lungs. Gram stain shows gram-negative coccobacilli- suggestive of Acinetobacter baumanii. A. baumannii is a notorious cause of nosocomial pneumonia Most frequently among patients requiring prolonged mechanical ventilation. It is resistant to all antibiotics except carbapenems and colistin.

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