Virulence Potential and Treatment Options of Multidrug-Resistant (MDR) Acinetobacter baumannii

Abstract

Acinetobacter baumannii is an opportunistic pathogen which is undoubtedly known for a high rate of morbidity and mortality in hospital-acquired infections. A. baumannii causes life-threatening infections, including; ventilator-associated pneumonia (VAP), meningitis, bacteremia, and wound and urinary tract infections (UTI). In 2017, the World Health Organization listed A. baumannii as a priority-1 pathogen. The prevalence of A. baumannii infections and outbreaks emphasizes the direct need for the use of effective therapeutic agents for treating such infections. Available antimicrobials, such as; carbapenems, tigecycline, and colistins have insufficient effectiveness due to the appearance of multidrug-resistant strains, accentuating the need for alternative and novel therapeutic remedies. To understand and overcome this menace, the knowledge of recent discoveries on the virulence factors of A. baumannii is needed. Herein, we summarized the role of various virulence factors, including; outer membrane proteins, efflux pumps, biofilm, penicillin-binding proteins, and siderophores/iron acquisition systems. We reviewed the recent scientific literature on different A. baumannii virulence factors and the effective antimicrobial agents for the treatment and management of bacterial infections.

Tigecycline Suppresses the Virulence Factors of Multidrug-Resistant Acinetobacter baumannii Allowing Human Neutrophils to Act

“… 19 , 35 Additionally, either monotherapy or combination therapy should be considered to treat MDRAB infection because there are differences in the effectiveness of bactericidal activity in vitro and in vivo. 36 Further studies are required to clarify the effectiveness of antimicrobial agents in the treatment and management of bacterial infections.…”

Clinical Features and Outcomes of Monobacterial and Polybacterial Episodes of Ventilator-Associated Pneumonia Due to Multidrug-Resistant Acinetobacter baumannii

“…It has established a niche in the hospital environment causing a variety of severe infections, especially in the critical care setting. It is usually a difficult-to-treat pathogen displaying a high resistance profile and has been associated with high mortality, morbidity, and health care costs [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Although some controversy exists in the relevant literature, it seems that the high mortality of infections caused by multidrug-resistant (MDR) pathogens may be related not only to the bacterial resistance but also to the severity of illness and the appropriateness and timeliness of antibacterial treatment [ 1 , 5 , 8 , 9 , 10 , 11 , 12 ].…”

Acinetobacter baumannii Resistance to Sulbactam/Durlobactam: A Systematic Review

“…The difficulty largely arises from the antibiotic resistance profile of the bacterium, which is one of the most resistant microorganisms encountered in clinics. Acinetobacter displays multiple antibiotic resistance mechanisms (often coexisting) such as: enzymatic; non-enzymatic, involving efflux pumps and membrane permeability; and penicillin-binding proteins (PBPs) mutations [ 1 , 2 ].…”