Acinetobacter baumannii: Envelope determinants that control drug resistance, virulence, and surface variability
June 14, 2019
Edward Geisinger, Wenwen Huo, Juan Hernandez-Bird, and Ralph R. Isberg
Annual Review of Microbiology Vol. 73:- (Volume publication date September 2019); Review in Advance first posted online on June 14, 2019. (Changes may still occur before final publication.
DOI: 10.1146/annurev-micro-020518-115714 | PMID: 31206345
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.