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FOR 2251:  Adaptation and Persistence of the Emerging Pathogen Acinetobacter baumannii

Subject Area Medicine
Term from 2014 to 2023
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Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 258351992
 
Acinetobacter baumannii is a Gram-negative opportunistic human pathogen that has become a global threat to healthcare institutions worldwide. Over the past decade, infections with MDR A. baumannii have steadily increased. Although there seems to be an increased geographic prevalence in Asia, even hospitals in Germany are hit by A. baumannii outbreaks. One of the largest outbreak in Germany was in January 2015 in the university hospital in Kiel, where 31 patients were colonized or infected and, unfortunately, 12 patients died. Members of our consortium were immediately available to help the colleagues in Kiel to contain the outbreak and to eliminate the bacteria. Other prominent outbreaks took place recently in the year 2017, e.g. in Stuttgart, Wiesbaden and Berlin, and there are many more described worldwide. Almost 45 % of all A. baumannii-isolates globally are considered to be multidrug resistant (MDR). This proportion is nearly four-fold higher than observed for other Gram-negative pathogens such as MDR-Pseudomonas aeruginosa and Klebsiella pneumoniae. In light of these growing resistance trends, the World Health Organization has placed carbapenem-resistant Acinetobacter on position 1 (together with carbapenem-resistant P. aeruginosa, and carbapenem-resistant, ESBL-producing Enterobacteriaceae) at its "critical" level in February 2017, to prioritize research and development efforts for new antimicrobial treatments. The success of A. baumannii in the hospital environment is based on its outstanding potential to adapt to very different, also extreme environments, and to persist in the host. The major threat is the rise of antibiotic resistance in A. baumannii. Currently, we witness the birth of multi- and pan drug resistance, even in Germany. A. baumannii is now entering center stage, and we now have today the problem that we cannot treat infections caused by pan-drug resistant A. baumanni. The situation is even getting worse: once considered to be exclusively healthcareacquired, we now see community-acquired infections, mainly occurring in south Asian countries. The importance of A. baumannii in the healthcare environment is increasing exponentially. Using "Acinetobacter baumannii", to query Pubmed revealed that 2.581 papers have been published in the last three years, compared to 3.921 in 65 years before. Still, our understanding of pathobiology, and the development of new antibacterial targets and therapeutics is lagging behind. There is a great need to comprehend the molecular basis underlying A. baumannii infections. As far as we know, our research group is still the only interdisciplinary group worldwide that addresses these questions.
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