Community-acquired carbapenem-resistant Acinetobacter baumannii pneumonia in an elderly woman with chronic kidney disease: A case report.

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a major cause of hospital-acquired infections but is rarely implicated in community-acquired pneumonia (CAP). We report the case of a 79-year-old woman with stage 3 chronic kidney disease who presented with severe CAP and respiratory failure. Bronchoscopy with bronchoalveolar lavage (BAL) identified CRAB sensitive to tobramycin and levofloxacin but resistant to all Beta-lactams and carbapenems. She was successfully treated with intravenous tobramycin and levofloxacin, followed by oral doxycycline and levofloxacin. Clinical and radiologic resolution was achieved by week 6. This case highlights a rare instance of community-acquired CRAB pneumonia and underscores the importance of BAL-based diagnosis and susceptibility-guided therapy, particularly in high-risk patients.