Acinetobacter species have emerged as significant nosocomial pathogens, severely complicating treatment protocols in tertiary care settings due to their rapid development of multidrug resistance (MDR). As an opportunistic pathogen, Acinetobacter baumannii is frequently associated with ventilator-associated pneumonia (VAP) and bloodstream infections, carrying substantial mortality rates. The primary mechanism driving this extensive beta-lactam resistance and the focal point of this review is the production of OXA-type carbapenem-hydrolyzing class D β-lactamases (CHDLs), alongside extended-spectrum beta-lactamases (ESBLs). The pathophysiology, virulence factors, clinical symptoms, and epidemiology of these resistant bacteria are all reviewed in this thorough analysis. Further, it describes the essential laboratory challenges and standard phenotypic methodologies needed to precisely isolate and profile these highly resistant Acinetobacter species from clinical specimens, as well as the molecular mechanisms underlying carbapenem resistance. Finally, given the high prevalence of these isolates in Indian intensive care units, this review evaluates the severe clinical outcomes associated with these strains and highlights essential therapeutic strategies. It emphasizes the urgent need for tailored combination therapies and explores the efficacy of novel targeted treatments, such as the sulbactam-durlobactam combination, in managing severe OXA-driven infections.
Ullengala et al. (Tue,) studied this question.
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