Abstract
Antibiotic resistance is one of the biggest challenges for the clinical sector and industry, environment and societal development. One of the most important pathogens responsible for severe nosocomial infections is Acinetobacter baumannii, a Gram-negative bacterium from the Moraxellaceae family, due to its various resistance mechanisms, such as the β-lactamases production, efflux pumps, decreased membrane permeability and altered target site of the antibiotic. The enormous adaptive capacity of A. baumannii and the acquisition and transfer of antibiotic resistance determinants contribute to the ineffectiveness of most current therapeutic strategies, including last-line or combined antibiotic therapy. In this review, we will present an update of the antibiotic resistance profiles and underlying mechanisms in A. baumannii and the current progress in developing innovative strategies for combating multidrug-resistant A. baumannii (MDRAB) infections.
Highlights
The global spread of antimicrobial resistance (AMR) is one of the global challenges of the 21st century
Two of the many reasons for the success of multidrug-resistant A. baumannii (MDRAB) strains are the association with chronic nosocomial infections and their unique ability to survive in extreme environmental conditions
Class C β-lactamases are encoded by the ampC gene found in Enterobacteriaceae and functionally is a non-inducible cephalosporinase framed by Bush and Jacoby into group 1 [72,73,74]
Summary
The global spread of antimicrobial resistance (AMR) is one of the global challenges of the 21st century. The resistance phenomenon was encountered in most common bacterial strains causing infections, associated with an increased risk of morbidity, mortality, high treatment costs and long periods of hospitalization. The Acb complex has become one of the biggest challenges in hospitals, primarily due to its increased resistance to carbapenems and other antibiotics, with minimal treatment options. Risk factors for colonization and infection with species within the Acb complex are extended periods of hospitalization, admission to ICUs, mechanical ventilation or exposure to antimicrobial agents [9]. Two of the many reasons for the success of MDRAB strains are the association with chronic nosocomial infections and their unique ability to survive in extreme environmental conditions. Many studies highlight the involvement with a very high frequency of resistant A. baumannii strains in different types of infections and the need to monitor the antibiotic consumption. Sputum, tracheal secretion, pleural fluid, blood culture, urine, cerebrospinal fluid/ ICU
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