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Emerging Threats: Multidrug Resistance and Clinical Challenges of Acinetobacter spp. in Modern Healthcare

Document Type : Review Article

Authors

Azadeh Taftian 1
Neda Abedi 2
Ali Zolfi Gol 3

1 Department of Obstetrics and Gynecology, Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran

2 Department of Microbiology, North Branch of Azad University, Tehran, Iran

3 Department of Pediatrics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

https://doi.org/10.22034/pmj.2025.2058093.1057
Abstract
Background:
Multidrug-resistant (MDR) bacteria, including Acinetobacter baumannii, have increased in healthcare systems, particularly in the Middle East. This bacterium is notoriously resistant to various medications, complicating disease therapy. The proliferation of XDR bacteria and the decline of effective antibiotics threaten patient safety and healthcare efficiency.
Objectives:
This study addresses the issues associated with MDR Acinetobacter baumannii in hospitals, especially in the Middle East. It examines the bacterium's epidemiology, molecular resistance mechanisms, clinical problems, and innovative treatment approaches. The research employs novel epidemiological data, molecular insights, and enhanced infection control strategies to comprehend the evolution of this issue and its management.
Methods:
We conducted a comprehensive study by searching PubMed, Scopus, and Web of Science for research published from 2010 to 2024. The investigation identified Middle Eastern research regarding the prevalence, resistance mechanisms, clinical care, and patient outcomes of MDR Acinetobacter baumannii. This study offers a comprehensive perspective on the escalating threat posed by this disease and its ramifications for regional healthcare professionals through the integration of qualitative and quantitative data.
Results:
Carbapenem-resistant Acinetobacter baumannii is common in 60–70% of Middle Eastern intensive care units and kills 40–50%. OXA-type carbapenemases, ESBLs, MBLs, efflux pump overexpression, target site changes, and biofilm formation make the bacterium resistant. We also found novel resistance determinants including bla_OXA-235 and regulatory gene alterations like adeRS. Overcrowded hospitals, long stays, antibiotic overuse, and poor infection control aggravate this issue. However, these issues are being fixed. Modern molecular diagnosis, ultraviolet disinfection, and genetic surveillance reduce these diseases.
Conclusions:
Increasing MDR Acinetobacter baumannii prevalence in the Middle East presents a difficult challenge that requires a coordinated, multidisciplinary approach. This pathogen's hazards can be reduced by improved antimicrobial stewardship, infection control, regional surveillance, and therapeutic development.

Keywords

MDR Acinetobacter baumannii
Multidrug resistance
Middle East
Carbapenem resistance
Novel therapeutics

Subjects

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Personalized and Precision Medicine Journal
Volume 10, Issue 37 - Serial Number 37
Original article
Spring 2025
Pages 20-30

  • Receive Date 11 February 2025
  • Revise Date 19 April 2025
  • Accept Date 25 May 2025

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