PSP 3 - Literature review presentation of Acinetobacter baumannii and relevant virulence, symptoms, diagnosis, antibiotic resistance, available and potential future treatments and how this review links to further study and a potential career.

1. Acinetobacter
baumannii

2. Introduction to the pathogen
 Characteristics
• Gram-negative
• Non-motile
• Non-fermentative
• Nosocomial
 Colonisation
• Soil
• Water
• Skin of healthy individuals
 Key abilities
• Horizontal gene transfer
• Biofilm

3. Virulence Factors
 Adherence
• Fimbria
• Outer Membrane Protein A (OmpA)
 Invasion
• Zipper-like mechanism – bacterial ligands
• Trigger mechanism – effector proteins
• Evasion

4. Symptoms and Diagnosis
 Symptoms and Similarities
 Diagnosis
• Difficult
• Non-pathogenic colonisation
• Symptom similarity
• Culture from sterile body fluid
Symptom Non-exhaustive
Potential Causes
References
Pneumonia Streptococcus
pneumoniae, Klebsiella
pneumoniae,
Pseudomonas aeruginosa
(Prina, Ranzani and Torres,
2015)
(Lu et al., 2014)
(Paczosa and Mecsas,
2016)
Sepsis Klebsiella pneumoniae,
Enterobacter spp.,
Streptococcus
pneumoniae, Neisseria
meningitidis
(Paczosa and Mecsas,
2016)
(Saravu et al., 2015)
(Kim et al., 2017)
(Herrmann et al., 2018)
Meningitis Streptococcus
pneumoniae, Neisseria
meningitidis, Listeria
monocytogenes
(Doran et al., 2016)
(Koopmans et al., 2014)
Urinary Tract Infection Escherichia coli, Klebsiella
pneumoniae,
(Paczosa and Mecsas,
2016)
(Croxen et al., 2013)

5. Antibiotic Resistance
 Efflux pumps
• Mechanically eject antibiotics
 Enzymatic defense
• Conformational change in antibiotic
structure
 Biofilm
• Altered metabolism

6. Treatments
 Outdated antibiotics
• Colistin
• Colistin-Vancomycin combination
 Toxicity
• Nephrotoxicity
• Neurotoxicity – to lesser degree
 Risks of treatment
• Kidney damage
• Greater risks if transplantation necessary
 Enterobacter aerogenes
• Colistin resistance (reported 24th Oct 2017)
• A. baumannii horizontal gene transfer

7. Further study and Career
 London School of Hygiene and Tropical Medicine
• Control of Infectious Disease
 Medical Microbiology
• Alternative therapies
• New antibiotics