Virulence Characteristics and Drug Resistance of the Prevalent Capsule Types in Acinetobacter baumannii.

Abstract

Acinetobacter baumannii is a highly antibiotic-resistant pathogen causing nosocomial severe life-threatening infections, especially in critically ill patients. Capsular polysaccharide is a major virulence factor of A. baumannii both in vitro and in vivo. In this study, 220 isolates were collected in the hospital. The prevalent capsular types of A. baumannii were determined using polymerase chain reaction, and the clinical characteristics of infections were analyzed. The virulence of these strains was determined by serum-killing resistance, biofilm formation, and Galleria mellonella survival assays. Twenty-eight isolates (12.7%) carried KL2, and 22 isolates (10%) carried the types KL10, KL14, KL22, and KL52. Compared with non-KL2 (KL10, KL14, KL22, and KL52) isolates, KL2 isolates had significantly higher resistance to all antimicrobials except tigecycline, cefoperazone-sulbactam, or colistin. Seventy-five percent of KL2 A. baumannii and 72.7% of non-KL2 were highly virulent using a G. mellonella model. Biofilm formation was significantly different between the KL2 and non-KL2 groups. The biofilm production of non-KL2 A. baumannii was significantly stronger than that of KL2 A. baumannii. These findings highlight the role of KL2 as a powerful factor for drug resistance and virulence of A. baumannii.