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Combating Multidrug-Resistant Acinetobacter baumannii: Insights from Japan, with Global Relevance.

Yusuke Yoshino1,2, Yoshitaka Kimura1, Fuyu Ito2

  • 1Department of Microbiology and Immunology, Teikyo University School of Medicine, Itabashi, Tokyo, Japan.

Infection and Drug Resistance
|December 22, 2025
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Summary

Acinetobacter baumannii, a critical pathogen, exhibits high multidrug resistance (MDR). This review details its resistance, epidemiology, diagnostics, and treatments, highlighting global variations in MDR A. baumannii prevalence.

Keywords:
antimicrobial stewardshipcarbapenemasecefiderocolglobal healthinfection controlsulbactam/durlobactam

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Area of Science:

  • Microbiology and Infectious Diseases
  • Antimicrobial Resistance Research
  • Global Health Security

Background:

  • Acinetobacter baumannii is a Gram-negative bacillus recognized for environmental persistence and rapid acquisition of multidrug resistance (MDR).
  • It is classified as a 'Critical' tier pathogen by the World Health Organization (2024) due to its significant threat.
  • High outbreak potential necessitates a comprehensive understanding of its characteristics and management.

Purpose of the Study:

  • To provide a comprehensive review of Acinetobacter baumannii.
  • To summarize key aspects including definitions, resistance mechanisms, epidemiology, diagnostics, infection control, and therapies.
  • To highlight global variations in resistance and inform preparedness strategies.

Main Methods:

  • Literature review synthesizing current knowledge on Acinetobacter baumannii.
  • Analysis of epidemiological data, focusing on resistance patterns in Japan and internationally.
  • Evaluation of diagnostic tools, infection control measures, and therapeutic options.

Main Results:

  • Carbapenem resistance in A. baumannii is primarily mediated by OXA-type carbapenemases, often in conjunction with other resistance mechanisms.
  • Significant geographical variations in resistance exist, with higher rates reported in Asia-Pacific and Latin America compared to Japan.
  • Effective outbreak control relies on both phenotypic and molecular diagnostic approaches.

Conclusions:

  • No single universally accepted treatment regimen exists for MDR Acinetobacter baumannii; combination therapy is frequently required.
  • Disparities in resistance levels may stem from differences in surveillance, infection control, and antimicrobial stewardship.
  • Understanding these contextual factors is crucial for developing effective, locally applicable strategies to combat increasing MDR A. baumannii burdens.