Escaping from ESKAPE. Clinical significance and antibiotic resistance mechanisms in acinetobacter baumannii: A review

Abstract

Antibiotic resistance represents a critical threat in clinical settings nowadays, with an essential ecological dimension. Due to the involvement of the resistance genes, this phenomenon has gained an unprecedented expansion. Their accumulation and dissemination are facilitated by mobile genetic elements (MGEs) (plasmids, transposons, integrons, genomic islands) that can increase intracellular DNA mobility. In clinical settings, one of the critical resistant bacteria associated with nosocomial infections is Acinetobacter baumannii. This Gram-negative bacterium exhibits variate resistance mechanisms that enable it to survive in extreme environmental conditions and to evade antimicrobial agents. The enormous adaptive capacity and the essential role in the emergence of severe nosocomial infections lead to the need to study more deeply the mechanisms involved in antibiotic resistance in A. baumannii strains. In this review, we will initially present the role of A. baumannii in human and veterinary infectious pathology. We will subsequently discuss the main genetic resistance mechanisms (both intrinsic and acquired) encountered in A. baumannii strains.