Acinetobacter baumannii Antibiotic Resistance Mechanisms
Abstract
:1. Introduction
2. Resistance to Beta-Lactams
2.1. Beta-Lactamases
2.1.1. Class A
2.1.2. Class B
2.1.3. Class C
2.1.4. Class D
2.2. Outer Membrane Proteins
2.3. Efflux Pumps
2.4. Penicillin-Binding Proteins
3. Resistance to Aminoglycosides
4. Resistance to Tetracyclines
5. Resistance to Fluoroquinolones
6. Resistance to Macrolides—Lincosamides—Streptogramin Antibiotics
7. Resistance to Polymyxins
8. Resistance to Others
8.1. Resistance to Amphenicols—Oxazolidinones
8.2. Resistance to Glycopeptide and Lipopetide Antibiotics
8.3. Resistance to Rifamycins
8.4. Resistance to Fosfomycin
8.5. Resistance to Diaminopyrimidines—Sulfonamides
9. SARS-CoV-2 and Resistant A. baumannii Coinfections
10. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Mechanism of Resistance | Element Name | Resistance | Element Symbol (Gene) | Protein Products | |
---|---|---|---|---|---|
Class A beta lactamases | class A broad-spectrum beta-lactamase TEM-1 | extended-spectrum | blaTEM-1 | WP_000027057.1 and others | |
class A extended-spectrum beta-lactamase SHV-5 | blaSHV-5 | WP_011117369.1 and others | |||
class A extended-spectrum beta-lactamase SHV-12 | blaSHV-12 | WP_002904004.1 and others | |||
carbapenem-hydrolyzing class A beta-lactamase GES-5 | blaGES-5 | WP_012658785.1 | |||
class A extended-spectrum beta-lactamase GES-11 | blaGES-11 | WP_001211000.1 and others | |||
class A beta-lactamase GES-12 | blaGES-12 | WP_063860500.1 and others | |||
inhibitor-resistant class A extended-spectrum beta-lactamase PER-1 | blaPER-1 | WP_001100753.1 and others | |||
class A extended-spectrum beta-lactamase PER-7 | blaPER-7 | WP_032495440.1 and others | |||
class A extended-spectrum beta-lactamase VEB-1 | blaVEB-1 | WP_000706731.1 and others | |||
class A extended-spectrum beta-lactamase CTX-M-15 | blaCTX-M-15 | WP_000239590.1 and others | |||
class A extended-spectrum beta-lactamase CTX-M-55 | blaCTX-M-55 | WP_015387340.1 | |||
class A extended-spectrum beta-lactamase CTX-M-115 | blaCTX-M-115 | WP_035895532.1 | |||
carbapenem-hydrolyzing class A beta-lactamase KPC-2 | blaKPC-2 | WP_004199234.1 and others | |||
Class B metallo-beta-lactamases | subclass B1 metallo-beta-lactamase NDM-1 | all (except monobactams) | blaNDM-1 | WP_004201164.1 and others | |
subclass B1 metallo-beta-lactamase IMP-1 | blaIMP-1 | WP_003159548.1 | |||
subclass B1 metallo-beta-lactamase IMP-4 | blaIMP-4 | WP_015060105.1 | |||
subclass B1 metallo-beta-lactamase IMP-14 | blaIMP-14 | WP_039819893.1 | |||
subclass B1 metallo-beta-lactamase IMP-16 | blaIMP-16 | WP_063860576.1 | |||
Class C beta-lactamases | class C extended-spectrum beta-lactamase ADC-11 | extended-spectrum | blaADC-11 | WP_001211205.1 and others | |
class C beta-lactamase ADC-25 | blaADC-25 | WP_001211217.1 and others | |||
class C extended-spectrum beta-lactamase ADC-26 | blaADC-26 | WP_001211238.1 and others | |||
class C extended-spectrum beta-lactamase ADC-30 | blaADC-30 | WP_001211218.1 and others | |||
cefepime-hydrolyzing class C extended-spectrum beta-lactamase ADC-33 | blaADC-33 | WP_001211220.1 and others | |||
class C extended-spectrum beta-lactamase ADC-52 | blaADC-52 | WP_001211232.1 and others | |||
cefepime-hydrolyzing class C extended-spectrum beta-lactamase ADC-56 | blaADC-56 | WP_031973850.1 and others | |||
class C extended-spectrum beta-lactamase ADC-73 | blaADC-73 | WP_001211219.1 and others | |||
class C extended-spectrum beta-lactamase ADC-74 | blaADC-74 | WP_001211203.1 and others | |||
class C extended-spectrum beta-lactamase ADC-76 | blaADC-76 | WP_001211237.1 and others | |||
class C extended-spectrum beta-lactamase ADC-79 | blaADC-79 | WP_001159760.1 and others | |||
class C extended-spectrum beta-lactamase ADC-80 | blaADC-80 | WP_029424536.1 and others | |||
class C extended-spectrum beta-lactamase ADC-82 | blaADC-82 | WP_001211216.1 and others | |||
class C beta-lactamase ADC-152 | CEPH | blaADC-152 | WP_001211233.1 and others | ||
class C beta-lactamase ADC-156 | blaADC-156 | WP_024436624.1 and others | |||
class C beta-lactamase ADC-162 | blaADC-162 | WP_031980335.1 and others | |||
class C beta-lactamase ADC-176 | blaADC-176 | WP_001159761.1 and others | |||
class C beta-lactamase ADC-182 | blaADC-182 | WP_057691114.1 and others | |||
class C beta-lactamase ADC-212 | blaADC-212 | WP_031975357.1 and others | |||
class C beta-lactamase ADC-222 | blaADC-222 | WP_031960999.1 and others | |||
Class D beta-lactamases (oxicillinases) | carbapenem-hydrolyzing class D beta-lactamase OXA-23 | CAR | blaOXA-23 | WP_001046004.1 and others | |
OXA-23 family carbapenem-hydrolyzing class D beta-lactamase OXA-239 | blaOXA-239 | WP_063862190.1 and others | |||
carbapenem-hydrolyzing class D beta-lactamase OXA-24 | CAR | blaOXA-24 | WP_012754353.1 and others | ||
OXA-24 family carbapenem-hydrolyzing class D beta-lactamase OXA-72 | blaOXA-72 | WP_000713530.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-51 | CAR | blaOXA-51 | WP_002033109.1 and others | ||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-64 | blaOXA-64 | WP_001021788.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-65 | blaOXA-65 | WP_001021782.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-66 | blaOXA-66 | WP_001021792.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-68 | blaOXA-68 | WP_001021775.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-69 | blaOXA-69 | WP_001021779.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-71 | blaOXA-71 | WP_001021785.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-82 | blaOXA-82 | WP_001021793.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-90 | blaOXA-90 | WP_001021781.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-91 | blaOXA-91 | WP_001021776.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-94 | blaOXA-94 | WP_029424390.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-95 | blaOXA-95 | WP_031960432.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-98 | blaOXA-98 | WP_001021777.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-100 | blaOXA-100 | WP_001021795.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-104 | blaOXA-104 | WP_024433915.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-120 | blaOXA-120 | WP_004738885.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-223 | blaOXA-223 | WP_001022758.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-259 | blaOXA-259 | WP_001021784.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-371 | blaOXA-371 | WP_063862738.1 and others | |||
OXA-51 family carbapenem-hydrolyzing class D beta-lactamase OXA-402 | blaOXA-402 | WP_001021789.1 and others | |||
carbapenem-hydrolyzing class D beta-lactamase OXA-58 | CAR | blaOXA-58 | WP_002002480.1 and others | ||
OXA-58 family carbapenem-hydrolyzing class D beta-lactamase OXA-96 | blaOXA-96 | WP_063864543.1 | |||
OXA-134 family carbapenem-hydrolyzing class D beta-lactamase OXA-235 | CAR | blaOXA-235 | WP_000854009.1 and others | ||
OXA-134 family carbapenem-hydrolyzing class D beta-lactamase OXA-237 | blaOXA-237 | WP_000854010.1 and others | |||
carbapenem-hydrolyzing class D beta-lactamase OXA-143 | CAR | blaOXA-143 | WP_063861042.1 | ||
OXA-143 family carbapenem-hydrolyzing class D beta-lactamase OXA-253 | blaOXA-253 | WP_032495764.1 | |||
Efflux pumps | multidrug efflux RND transporter AdeABC outer membrane channel subunit AdeC | CEPH, CAR | adeC | WP_000047249.1 and others | |
Acinetobacter baumannii efflux resistant AdeR | adeR_A91V | WP_039198290.1 and others | |||
Acinetobacter baumannii efflux resistant AdeR | adeR_P56S | WP_088753133.1 and others | |||
Acinetobacter baumannii efflux resistant AdeR | adeR_P116L | WP_111853508.1 and others | |||
Acinetobacter baumannii efflux resistant AdeS | adeS_G336S, adeS_N125K | WP_031975145.1, WP_057691178.1 and others | |||
Acinetobacter baumannii efflux resistant AdeS | adeS_H189Y | WP_119491814.1, WP_000837466.1, WP_046882653.1 | |||
Penicillin-binding proteins | Acinetobacter baumannii carbapenem resistant FtsI | CAR | ftsI_A515V | WP_000227939.1 and others (penicillin-binding protein PBP3) |
Element Name and Symbol | Resistance | Gene | Protein Products | |
---|---|---|---|---|
Aminoglycoside acetyltransferases | Aminoglycoside 2’-N-acetyltransferase AAC(2’)-Ib | GEN, TOB, DIB, NET [101] | aac(2′)-Ib | WP_001159732.1 † |
Aminoglycoside 3-N-acetyltransferase | GEN | aac(3) | WP_195206917.1 | |
AAC(3)-I family aminoglycoside 3-N-acetyltransferase | GEN | aac(3)-I | HAV6561382.1, WP_069597335.1 | |
Aminoglycoside N-acetyltransferase AAC(3)-Ia | AST, GEN, SIS [102] | aac(3)-Ia | WP_002089484.1, and others | |
Aminoglycoside N-acetyltransferase AAC(3)-IId | GEN | aac(3)-IId | WP_000557454.1, WP_126562472.1 | |
Aminoglycoside N-acetyltransferase AAC(3)-IIe | GEN | aac(3)-IIe | WP_000557452.1, WP_002063884.1, WP_033107705.1, WP_095530619.1, and others | |
Aminoglycoside N-acetyltransferase AAC(3)-Iva | APR, GEN, TOB | aac(3)-IVa | WP_001199192.1 | |
Aminoglycoside 6’-N-acetyltransferase | all | aac(6’) | HAV4276337.1 | |
Aminoglycoside N-acetyltransferase AAC(6’)-31 | all | aac(6’)-31 | WP_044424439.1 | |
Aminoglycoside 6’-N-acetyltransferase AAC(6’)-33 | all | aac(6’)-33 | WP_015059044.1 | |
AAC(6’)-Ia family aminoglycoside 6’-N-acetyltransferase | AMI, KAN, TOB, putatively against all | aac(6’) | EGY2236091.1, EGY5968849.1, WP_088756823.1, WP_088774065.1, WP_140976846.1 | |
AAC(6’)-Ia family aminoglycoside 6’-N-acetyltransferase AacA16 | all | aacA16 | WP_001109644.1 | |
Aminoglycoside 6’-N-acetyltransferase AacA34 | all | aacA34 | WP_052285801.1 | |
AAC(6’)-Ia family aminoglycoside 6’-N-acetyltransferase AacA43 | KAN, TOB | aacA43 | WP_024437351.1 | |
Aminoglycoside N-acetyltransferase AAC(6’)-Ian | AMI, KAN, TOB, putatively against all | aac(6’)-Ian or aacA57-2 | WP_000960976.1 | |
AAC(6’)-Ib family aminoglycoside 6’-N-acetyltransferase | AMI, DIB, GEN, ISE, KAN, NET, SIS, TOB [102] | aac(6’)-Ib | WP_063840280.1, and others | |
Aminoglycoside N-acetyltransferase AAC(6’)-Ib’ | GEN | aac(6’)-Ib’ | WP_014454105.1 | |
AAC(6’)-Ighjkrstuvwx family aminoglycoside N-acetyltransferase | AMI, KAN, TOB | aac(6’)-I | WP_169109636.1, WP_150956588.1, WP_005288246.1, WP_005243483.1 | |
Aminoglycoside N-acetyltransferase AAC(6’)-Ib3 | AMI, KAN, TOB | aac(6’)-Ib3 | WP_032488579.1 | |
Aminoglycoside N-acetyltransferase AAC(6’)-Ib4 | GEN | aac(6’)-Ib4 | WP_003159191.1 | |
aminoglycoside N-acetyltransferase AAC(6’)-Ih | AMI, KAN, TOB | aac(6’)-Ih | WP_016541245.1 † | |
Aminoglycoside N-acetyltransferase AAC(6’)-Il | AMI, KAN, TOB | aac(6’)-Il | WP_156193962.1 | |
AAC(6’)-II family aminoglycoside 6’-N-acetyltransferase AacA35 | GEN, KAN, TOB | aacA35 | WP_024437054.1 | |
Aminoglycoside N-acetyltransferase AAC(6’)-IIc | GEN, KAN, TOB | aac(6’)-IIc | WP_149959345.1, WP_149938250.1 | |
Fluoroquinolone-acetylating aminoglycoside 6’-N-acetyltransferase AAC(6’)-Ib-cr | AMI, KAN, TOB, QUI | aac(6’)-Ib-cr | WP_185936887.1 | |
Fluoroquinolone-acetylating aminoglycoside 6’-N-acetyltransferase AAC(6’)-Ib-cr5 | AMI, KAN, TOB, QUI | aac(6’)-Ib-cr5 | WP_063840321.1 | |
Aminoglycoside adenyltransferases | Aminoglycoside nucleotidyltransferase ANT(2’’)-Ia | DIB, GEN, KAN, SIS, TOB [102] | ant(2’’)-Ia | WP_000381802.1, and others |
ANT(3’’)-I family aminoglycoside nucleotidyltransferase | STR, SPE | ant(3’’) | WP_038350223.1 | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA | STR, SPE | ant(3’’)-Ia | WP_001205725.1 | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA1 | STR | aadA1 | WP_001206316.1, and others | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA2 | STR | aadA2 | WP_001206356.1, WP_001261740.1, and others | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA5 | STR | aadA5 | WP_000503573.1, WP_000503574.1 | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA11 | STR | aadA11 | WP_048608579.1, HAV4466908.1 | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA13 | STR | aadA13 | WP_001424636.1 † | |
ANT(3’’)-Ia family aminoglycoside nucleotidyltransferase AadA16 | STR | aadA16 | WP_001749984.1, WP_185936919.1 | |
ANT(3’’)-II family aminoglycoside nucleotidyltransferase | STR, SPE | ant(3’’)-II | WP_005240470.1 | |
Aminoglycoside nucleotidyltransferase ANT(3’’)-IIa | STR, SPE | ant(3’’)-IIa | WP_001279062.1, WP_001279061.1,WP_001112625.1, and others | |
Aminoglycoside nucleotidyltransferase ANT(3’’)-IIc | STR, SPE | ant(3’’)-IIc | WP_005281276.1 | |
Aminoglycoside phosphotransferases | APH(3’) family aminoglycoside O-phosphotransferase | all | aph(3’) | WP_196077463.1 |
Aminoglycoside O-phosphotransferase APH(3’)-Ia | GEN, KAN, NEO, PAR, LIV, RIB [102] | aph(3’)-Ia | WP_000018326.1, and others | |
APH(3’)-II family aminoglycoside O-phosphotransferase | KAN | aph(3’)-II | WP_000262467.1 | |
Aminoglycoside O-phosphotransferase APH(3’)-IIa | KAN | aph(3’)-IIa | WP_000572405.1, WP_171502934.1, and others | |
APH(3’)-VI family aminoglycoside O-phosphotransferase | AMI, KAN | aph(3’)-VI | WP_014386410.1, and others | |
Aminoglycoside O-phosphotransferase APH(3’)-VIa | AMI, KAN | aph(3’)-VIa | WP_000422636.1, and others | |
Aminoglycoside O-phosphotransferase APH(3’)-VIb | AMI, KAN | aph(3’)-VIb | WP_000422633.1, WP_000422632.1, and others | |
Aminoglycoside O-phosphotransferase APH(3’’)-Ib | STR | aph(3’’)-Ib | WP_001082319.1, and others | |
Aminoglycoside O-phosphotransferase APH(4)-Ia | HYG | aph(4)-Ia | WP_185218783.1 | |
Aminoglycoside O-phosphotransferase APH(6)-Id | STR | aph(6)-Id | WP_000480968.1, and others | |
Target mutation: 16S rRNA methylase genes | ArmA family 16S rRNA (guanine(1405)-N(7))-methyltransferase | GEN | armA | WP_000359986.1, and others |
16S rRNA (guanine(1405)-N(7))-methyltransferase RmtB1 | all | rmtB and rmtB1 | WP_012372818.1 | |
RmtE family 16S rRNA (guanine(1405)-N(7))-methyltransferase | all | rmtE | WP_120494548.1 | |
Efflux pump overactivity | Multidrug efflux MFS transporter AmvA | Putatively against all | amvA | WP_001170321.1, and others |
Multidrug efflux RND transporter AdeABC outer membrane channel subunit AdeC | adeC | WP_000047249.1, and others | ||
Multidrug efflux RND transporter periplasmic adaptor subunit AdeD | adeD | WP_002119008.1, WP_039254548.1 | ||
Multidrug efflux RND transporter permease subunit AdeE | adeE | WP_002118518.1, WP_039254549.1 | ||
Efflux system DNA-binding response regulator transcription factor AdeR | adeR | WP_032002707.1, EGY8404952.1,WP_020752724.1 | ||
Two-component sensor histidine kinase AdeS two-component sensor histidine kinase | adeS | WP_031975145.1, and others | ||
Multidrug efflux SMR transporter EmrE | emrE | WP_109847152.1 |
Element name and symbol | Resistance | Gene | Protein products |
---|---|---|---|
Tetracycline efflux MFS transporter Tet(39) | DOX, TET [110,111] | tet(39) | WP_004856455.1, and others |
Tetracycline efflux MFS transporter Tet(A) | DOX, MIN, TET, TIG * | tet(A) | WP_000804064.1, and others |
tetracycline efflux MFS transporter Tet(B) | DOX, MIN, TET [111] | tet(B) | WP_001089072.1, and others |
Tetracycline efflux MFS transporter Tet(C) | TET [112] | tet(C) | WP_000841448.1 |
Tetracycline efflux MFS transporter Tet(D) | TET [113] | tet(D) | WP_024436252.1 |
Tetracycline efflux MFS transporter Tet(G) | DOX, MIN, TET | tet(G) | WP_001257840.1 |
Tetracycline efflux MFS transporter Tet(H) | OXY, TET [114] | tet(H) | WP_006248867.1 |
Tetracycline resistance ribosomal protection protein Tet(M) | TET, MIN | tet(M) | WP_000691727.1 |
Tetracycline-inactivating monooxygenase Tet(X) | all | tet(X) | WP_024160783.1, and others |
Element Name and Symbol | Resistance | Gene | Protein Products |
---|---|---|---|
Fluoroquinolone-acetylating aminoglycoside 6’-N-acetyltransferase AAC(6’)-Ib-cr | CIP, NOR | aac(6’)-Ib-cr | WP_185936887.1 |
Fluoroquinolone-acetylating aminoglycoside 6’-N-acetyltransferase AAC(6’)-Ib-cr5 | CIP, NOR | aac(6’)-Ib-cr5 | WP_063840321.1 |
A. baumannii quinolone resistant GyrA (DNA gyrase subunit A) | CIP, LEV | gyrA_S81L | WP_000116444.1, and others |
A. baumannii quinolone resistant ParC (DNA topoisomerase IV subunit A) | CIP, LEV | parC_E88K | WP_000202265.1, and others |
A. baumannii quinolone resistant ParC (DNA topoisomerase IV subunit A) | CIP, LEV | parC_S84F | WP_000202250.1, and others |
A. baumannii quinolone resistant ParC (DNA topoisomerase IV subunit A) | CIP, LEV | parC_S84L | WP_000202252.1, and others |
QnrA family quinolone resistance pentapeptide repeat protein | CIP | qnrA | HAV5951840.1 |
QnrB family quinolone resistance pentapeptide repeat protein | CIP | qnrB | WP_185936934.1 |
Quinolone resistance pentapeptide repeat protein QnrB19 | CIP | qnrB19 | WP_012954666.1 |
QnrS family quinolone resistance pentapeptide repeat protein | CIP, * | qnrS | WP_147508156.1 |
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Kyriakidis, I.; Vasileiou, E.; Pana, Z.D.; Tragiannidis, A. Acinetobacter baumannii Antibiotic Resistance Mechanisms. Pathogens 2021, 10, 373. https://doi.org/10.3390/pathogens10030373
Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii Antibiotic Resistance Mechanisms. Pathogens. 2021; 10(3):373. https://doi.org/10.3390/pathogens10030373
Chicago/Turabian StyleKyriakidis, Ioannis, Eleni Vasileiou, Zoi Dorothea Pana, and Athanasios Tragiannidis. 2021. "Acinetobacter baumannii Antibiotic Resistance Mechanisms" Pathogens 10, no. 3: 373. https://doi.org/10.3390/pathogens10030373