ARC Centre of Excellence in Synthetic Biology, School of Natural Sciences, Macquarie University, Sydney, NSW, Australia.
Australian Institute of Microbiology and Infection, University of Technology Sydney, Ultimo, NSW, Australia.
PLoS Pathog. 2023 Aug 10;19(8):e1011520. doi: 10.1371/journal.ppat.1011520. eCollection 2023 Aug.
Antibiotic resistance is a growing global concern in the field of medicine as it renders bacterial infections difficult to treat and often more severe. Acinetobacter baumannii is a gram-negative bacterial pathogen causing a wide range of infections, including pneumonia, sepsis, urinary tract infections, and wound infections. A. baumannii has emerged as a significant healthcare-associated pathogen due to its high level of antibiotic resistance. The global spread of antibiotic-resistant strains of A. baumannii has resulted in limited treatment options, leading to increased morbidity and mortality rates, especially in vulnerable populations such as the elderly and immunocompromised individuals, as well as longer hospital stays and higher healthcare costs. Further complicating the situation, multi- and pan-drug-resistant strains of A. baumannii are becoming increasingly common, and these deadly strains are resistant to all or almost all available antibiotics. A. baumannii employs various clever strategies to develop antibiotic resistance, including horizontal transfer of resistance genes, overexpression of inherent efflux pumps that remove drugs from the cell, intrinsic mutations, combined with natural selection under antibiotic selective pressure leading to emergence of successful resistance clones. The typical multidrug resistance phenotype of A. baumannii is, therefore, an orchestrated collimation of all these mechanisms combined with the worldwide spread of "global clones," rendering infections caused by this pathogen challenging to control and treat. To address the escalating problem of antibiotic resistance in A. baumannii, there is a need for increased surveillance, strict infection control measures, and the development of new treatment strategies, requiring a concerted effort by healthcare professionals, researchers, and policymakers.
抗生素耐药性是医学领域日益严重的全球问题，因为它使细菌感染难以治疗，而且往往更严重。鲍曼不动杆菌是一种革兰氏阴性细菌病原体，可引起多种感染，包括肺炎、败血症、尿路感染和伤口感染。由于其高水平的抗生素耐药性，鲍曼不动杆菌已成为一种重要的与医疗保健相关的病原体。具有抗生素耐药性的鲍曼不动杆菌在全球的传播导致治疗选择有限，从而导致发病率和死亡率上升，特别是在老年人和免疫功能低下等弱势群体以及住院时间延长和医疗费用增加。更复杂的是，多药和泛耐药鲍曼不动杆菌菌株越来越常见，这些致命菌株对所有或几乎所有可用的抗生素都具有耐药性。鲍曼不动杆菌采用多种巧妙的策略来产生抗生素耐药性，包括耐药基因的水平转移、过度表达将药物从细胞中排出的固有外排泵、内在突变，以及在抗生素选择压力下的自然选择相结合，导致成功的耐药克隆的出现。因此，鲍曼不动杆菌的典型多药耐药表型是所有这些机制的协同集中，再加上“全球克隆”的全球传播，使得由这种病原体引起的感染难以控制和治疗。为了解决鲍曼不动杆菌中抗生素耐药性不断升级的问题，需要加强监测、严格的感染控制措施以及新的治疗策略的制定，这需要医疗保健专业人员、研究人员和政策制定者共同努力。
