Acinetobacter baumannii: an evolving and cunning opponent

Jingchao Shi; Jianghao Cheng; Shourong Liu; Yufeng Zhu; Mingli Zhu

doi:10.3389/fmicb.2024.1332108

Acinetobacter baumannii: an evolving and cunning opponent

Front Microbiol. 2024 Jan 22:15:1332108. doi: 10.3389/fmicb.2024.1332108. eCollection 2024.

Authors

Jingchao Shi^{1

2

3}, Jianghao Cheng¹, Shourong Liu⁴, Yufeng Zhu¹, Mingli Zhu¹

Affiliations

¹ Open Laboratory Medicine, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
² Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
³ Graduate School, Zhejiang Chinese Medical University, Hangzhou, China.
⁴ Department of Infectious Disease, 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.

Keywords: Acinetobacter baumannii; antimicrobial resistance; polymyxin; resistance mechanisms; tigecycline.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Science and Technology Project from Health Commission of Zhejiang Province of the People’s Republic of China (grant number 2023KY974) and the Hangzhou Health Science and Technology Key project (grant number ZD20220040). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.