The ability of Acinetobacter baumannii to adhere to and persist on surfaces as biofilms could be central to its pathogenicity. The production of pili and a biofilm-associated protein and the expression of antibiotic resistance are needed for robust biofilm formation on abiotic and biotic surfaces. This multistep process also depends on the expression of transcriptional regulatory functions, some of which could sense nutrients available to cells. This report extends previous observations by showing that although outer membrane protein A (OmpA) of A. baumannii 19606 plays a partial role in the development of robust biofilms on plastic, it is essential for bacterial attachment to Candida albicans filaments and A549 human alveolar epithelial cells. In contrast to abiotic surfaces, the interaction with biotic surfaces is independent of the CsuA/BABCDE-mediated pili. The interaction of A. baumannii 19606 with fungal and epithelial cells also results in their apoptotic death, a response that depends on the direct contact of bacteria with these two types of eukaryotic cells. Furthermore, the bacterial adhesion phenotype correlates with the ability of bacteria to invade A549 epithelial cells. Interestingly, the killing activity of cell-free culture supernatants proved to be protease and temperature sensitive, suggesting that its cytotoxic activity is due to secreted proteins, some of which are different from OmpA.The genus Acinetobacter is a genetically diverse group of aerobic, gram-negative, nonfermenting bacteria (48, 49). Although acinetobacters are commonly described as being ubiquitous nonpathogenic bacteria, those strains belonging to the Acinetobacter baumannii-Acinetobacter calcoaceticus cluster are emerging as relevant opportunistic human pathogens due to their increases in virulence and multidrug resistance (13,32,34). Members of this genus play an important role in nosocomial infections and have attracted particular attention in severe cases associated with intensive care unit patients (4, 53). These infections manifest as serious diseases in compromised human hosts, particularly in cases of ventilator-acquired pneumonia, urinary tract infections, septicemia, and wound infections. More recently, A. baumannii has emerged as a serious pathogen among soldiers returning from Iraq and Afghanistan, with those suffering penetrating injuries being at the highest risk (9,12,13,32,34,57). These are some of the reports that demonstrate the emergence of A. baumannii as a relevant pathogen that causes severe infections in civilian and military medical facilities. These infections are extremely difficult to handle because of the multiple-antibiotic-resistance phenotype of most clinical isolates.The capacity of A. baumannii to cause disease in compromised patients and persist in the medical environment could be attributed to its resistance to major antimicrobial drugs (34) and desiccation (18), the latter of which is greater than that described for the Enterobacteriaceae and similar to that observed for Staphylococcus aureu...