Acinetobacter baumannii: Envelope Determinants That Control Drug Resistance, Virulence, and Surface Variability

Acinetobacter baumannii has emerged as an important nosocomial pathogen, particularly for patients in intensive care units and with invasive indwelling devices. The most recent clinical isolates are resistant to several classes of clinically important antibiotics, greatly restricting the ability to...

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Bibliographic Details
Published in:Annual review of microbiology 2019-09, Vol.73 (1), p.481-506
Main Authors: Geisinger, Edward, Huo, Wenwen, Hernandez-Bird, Juan, Isberg, Ralph R
Format: Article
Language:English
Subjects:
Acinetobacter
Acinetobacter baumannii
antibiotic resistance
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
Antimicrobial resistance
capsule
Carbohydrates
cell envelope
Clinical isolates
drug efflux
Drug resistance
Hospitals
Immune response
Intensive care units
lipooligosaccharide
Mutation
Nosocomial infection
Regulatory mechanisms (biology)
Virulence
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Summary:Acinetobacter baumannii has emerged as an important nosocomial pathogen, particularly for patients in intensive care units and with invasive indwelling devices. The most recent clinical isolates are resistant to several classes of clinically important antibiotics, greatly restricting the ability to effectively treat critically ill patients. The bacterial envelope is an important driver of A. baumannii disease, both at the level of battling against antibiotic therapy and at the level of protecting from host innate immune function. This review provides a comprehensive overview of key features of the envelope that interface with both the host and antimicrobial therapies. Carbohydrate structures that contribute to protecting from the host are detailed, and mutations that alter these structures, resulting in increased antimicrobial resistance, are explored. In addition, protein complexes involved in both intermicrobial and host-microbe interactions are described. Finally we discuss regulatory mechanisms that control the nature of the cell envelope and its impact on host innate immune function.
ISSN:0066-4227
1545-3251
DOI:10.1146/annurev-micro-020518-115714