Carbapenem resistance in Acinetobacter baumannii: laboratory challenges, mechanistic insights and therapeutic strategies

Expert Rev Anti Infect Ther. 2013 Apr;11(4):395-409. doi: 10.1586/eri.13.21.


Unprecedented levels of antimicrobial resistance in bacterial isolates have prompted great concerns globally. In 2012 the WHO released a publication outlining the evolving threat of antimicrobial resistance in order to raise awareness and to stimulate coordinated international efforts. The carbapenem class of antibiotics is largely considered as an antibiotic of last-resort when treating infections. Now carbapenem resistance further limits treatment options. In this article the authors discuss carbapenem resistance in Acinetobacter baumannii, a bacterial isolate often implicated in nosocomial infections. Virulence factors, intrinsic and acquired resistance mechanisms, together with laboratory challenges in the detection and antibiotic susceptibility testing of A. baumannii make this a truly problematic isolate. Therapeutic options are exceedingly limited, relying on polymyxins in combinations with other antibiotics, with few, if any, new active agents in the pipeline.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter Infections / epidemiology*
  • Acinetobacter Infections / microbiology
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / genetics*
  • Aminoglycosides / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Carbapenems / therapeutic use
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Disease Management
  • Epidemiological Monitoring
  • Humans
  • Polymyxins / therapeutic use
  • Porins / deficiency
  • Porins / genetics
  • beta-Lactam Resistance / drug effects
  • beta-Lactam Resistance / genetics*
  • beta-Lactamases / genetics


  • Aminoglycosides
  • Anti-Bacterial Agents
  • Carbapenems
  • Polymyxins
  • Porins
  • beta-Lactamases