Antimicrobial Resistance in Acinetobacter baumannii Infections
Summary
Acinetobacter baumannii has emerged as a pre-eminent cause of hospital-acquired infections, particularly in intensive care settings and among immunocompromised or traumatised patients. Its remarkable capacity to acquire and accumulate antimicrobial resistance determinants has rendered many first-line antibiotics ineffective. Key resistance mechanisms include production of β-lactam-hydrolysing enzymes, up-regulation of multidrug efflux pumps, reduced outer membrane permeability and target-site modifications. These adaptations enable survival under antibiotic pressure and facilitate transmission via contaminated surfaces, medical devices and environmental reservoirs. Clinically, A. baumannii causes ventilator-associated pneumonia, bloodstream infections, wound and soft-tissue infections, and occasionally meningitis, often with high morbidity and mortality rates. Treatment options have narrowed to polymyxins, tigecycline and combination regimens, but emerging resistance to these last-resort agents has intensified the urgency for novel diagnostics, antimicrobial stewardship and alternative therapies, including bacteriophage-based approaches. The global distribution of multidrug-resistant and extensively drug-resistant strains underscores a One Health imperative, linking human health, environmental contamination and agricultural antibiotic use. Coordinated surveillance, rapid detection and stringent infection-control practices remain critical to curb further dissemination and preserve the dwindling armamentarium against this formidable pathogen.
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Antimicrobial Resistance in Acinetobacter baumannii Infections publication trend
The graph below shows the total number of articles in antimicrobial resistance in acinetobacter baumannii infections across all publications each year (not limited to Nature Index journals).
Technical terms
Multidrug-resistant (MDR): Bacterial strains resistant to three or more classes of antimicrobial agents.
Carbapenem-resistant A. baumannii (CRAB): A. baumannii strains exhibiting resistance to carbapenem antibiotics, often via carbapenemase enzymes.
β-lactamases: Enzymes that hydrolyse the β-lactam ring of penicillins, cephalosporins and carbapenems, neutralising their antibacterial activity.
Efflux pumps: Membrane proteins that actively expel diverse antibiotics from the bacterial cell, lowering intracellular drug concentrations.
Loop-mediated isothermal amplification (LAMP): A nucleic acid amplification technique that operates at a constant temperature, enabling rapid target detection without thermal cycling.
Lateral flow assay (LFA): A paper-based platform for the visual detection of specific biomolecules, often used in point-of-care diagnostics.
Biofilm: Structured communities of bacteria adherent to surfaces and embedded in a self-produced matrix, conferring heightened resistance to antimicrobials and immune clearance.
References
- Biology of Acinetobacter baumannii: Pathogenesis, Antibiotic Resistance Mechanisms, and Prospective Treatment Options. Frontiers in Cellular and Infection Microbiology (2017).
- Isothermal Amplification and Hypersensitive Fluorescence Dual-Enhancement Nucleic Acid Lateral Flow Assay for Rapid Detection of Acinetobacter baumannii and Its Drug Resistance. Biosensors (2023).
- Antibiotic Resistance Profiles, Molecular Mechanisms and Innovative Treatment Strategies of Acinetobacter baumannii. Microorganisms (2020).
- Detection of antibiotic resistant Acinetobacter baumannii in various hospital environments: potential sources for transmission of Acinetobacter infections. Environmental Health and Preventive Medicine (2017).
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