Acinetobacter baumannii: an evolving and cunning opponent
Jingchao Shi1,2,3, Jianghao Cheng1, Shourong Liu4
1Open Laboratory Medicine, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
Abstract:
Acinetobacter baumannii is one of the most common multidrug-resistant pathogens causing nosocomial infections. The prevalence of multidrug-resistant A. baumannii infections is increasing because of several factors, including unregulated antibiotic use. A. baumannii drug resistance rate is high; in particular, its resistance rates for tigecycline and polymyxin-the drugs of last resort for extensively drug-resistant A. baumannii-has been increasing annually. Patients with a severe infection of extensively antibiotic-resistant A. baumannii demonstrate a high mortality rate along with a poor prognosis, which makes treating them challenging. Through carbapenem enzyme production and other relevant mechanisms, A. baumannii has rapidly acquired a strong resistance to carbapenem antibiotics-once considered a class of strong antibacterials for A. baumannii infection treatment. Therefore, understanding the resistance mechanism of A. baumannii is particularly crucial. This review summarizes mechanisms underlying common antimicrobial resistance in A. baumannii, particularly those underlying tigecycline and polymyxin resistance. This review will serve as a reference for reasonable antibiotic use at clinics, as well as new antibiotic development.
Insights
Multidrug-resistant Acinetobacter baumannii infections are rising due to factors like antibiotic misuse. Understanding resistance mechanisms is crucial for developing new treatments and ensuring appropriate antibiotic use.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Acinetobacter baumannii is a leading cause of hospital-acquired infections.
- Increasing resistance to last-resort antibiotics like tigecycline and polymyxin poses a significant clinical challenge.
- High mortality rates are associated with extensively drug-resistant A. baumannii infections.
Purpose of the Study:
- To review common antimicrobial resistance mechanisms in Acinetobacter baumannii.
- To specifically focus on the mechanisms conferring resistance to tigecycline and polymyxin.
- To provide a reference for clinical antibiotic use and guide new drug development.
Main Methods:
- Literature review of antimicrobial resistance mechanisms in Acinetobacter baumannii.
- Analysis of studies detailing resistance to tigecycline and polymyxin.
- Synthesis of information on carbapenemase production and other resistance pathways.
Main Results:
- Acinetobacter baumannii exhibits high drug resistance rates, including to carbapenems.
- Mechanisms such as carbapenemase production contribute to resistance.
- Increasing resistance to last-resort drugs threatens effective treatment options.
Conclusions:
- Understanding A. baumannii resistance mechanisms is critical for clinical practice.
- This review aids in promoting rational antibiotic prescribing.
- Knowledge of resistance pathways can inform the development of novel antimicrobial agents.
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