Acinetobacter baumannii Resistance: A Real Challenge for Clinicians

Abstract

Acinetobacter baumannii (named in honor of the American bacteriologists Paul and Linda Baumann) is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients with central venous catheters. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections; most involve the respiratory tract, especially ventilator-associated pneumonia, but bacteremia and skin wound infections have also been reported, the latter of which has been prominently observed in the context of war-related trauma. Cases of meningitis associated with A. baumannii have been documented. The most common risk factor for the acquisition of MDR A baumannii is previous antibiotic use, following by mechanical ventilation, length of ICU/hospital stay, severity of illness, and use of medical devices. Current efforts focus on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme. Bacteriophage- and artilysin-based therapeutic approaches have been described as effective, but further research into their clinical use is required

A Multi-epitope Peptide rOmp22 Encapsulated in Chitosan-PLGA Nanoparticles as Vaccine Candidate Against Acinetobacter baumannii Infection

“…Multidrug-resistant A. baumannii is a rapidly emerging pathogen causing infections with high mortality rates due to inadequate medical treatment [1,2,6]. New ways to prevent and treat such infections are of a critical medical need.…”

“…Acinetobacter baumannii is an opportunistic pathogen that predominantly causes pneumonia, bacteremia, meningitis, and urinary tract infections in patients. A. baumannii has recently emerged as one of the most important health problems due to its propensity to acquire multi-drug, extensive drug and even pan-drug resistance phenotypes at previously unforeseen rates [1][2][3]. The main antibiotic resistant mechanisms include alteration in the target sites, failure in the degradation-speci c enzymes, perfusion defects and modi cation in multidrug effusion pumps [1,4].…”

“…A. baumannii has recently emerged as one of the most important health problems due to its propensity to acquire multi-drug, extensive drug and even pan-drug resistance phenotypes at previously unforeseen rates [1][2][3]. The main antibiotic resistant mechanisms include alteration in the target sites, failure in the degradation-speci c enzymes, perfusion defects and modi cation in multidrug effusion pumps [1,4]. Besides, A. baumannii has a number of potential virulence factors, such as siderophore-mediated iron-acquistion system and bio lm formation, which could possibly affect clinical outcomes [5].…”

<p>Successful Incidences of Controlling Multidrug-Resistant, Extensively Drug-Resistant, and Nosocomial Infection <em>Acinetobacter baumannii</em> Using Antibiotic Stewardship, Infection Control Programs, and Environmental Cleaning at a Chinese University Hospital</p>

“…3,4 It must be noted that a high mortality rate has been associated with infections caused by CRAB strains. 5 The rapid spread of MDRAB and XDRAB in clinical settings has made choosing an appropriate antibiotic to treat these infections and executing contact precautions difficult for clinicians; indeed, institutional outbreaks caused by MDRAB and XDRAB are a tremendous public health problem. 3,5 Although controlling the transmission of MDRAB and XDRAB is a high priority for hospitals, there is little information and data about MDRAB and XDRAB control.…”

“…5 The rapid spread of MDRAB and XDRAB in clinical settings has made choosing an appropriate antibiotic to treat these infections and executing contact precautions difficult for clinicians; indeed, institutional outbreaks caused by MDRAB and XDRAB are a tremendous public health problem. 3,5 Although controlling the transmission of MDRAB and XDRAB is a high priority for hospitals, there is little information and data about MDRAB and XDRAB control. 1 The limited or even no effective treatment options make the clinical management of MDRAB and XDRAB infections particularly challenging.…”