Avanços na terapia antimicrobiana em infecções causadas pela espécie Acinetobacter baumannii

Abstract

Acinetobacter baumannii is often associated to healthcare-associated infections, representing a serious public health problem, as it increases the risk of death in critically ill and immunocompromised patients. The species has the ability to express resistance to multiple antimicrobials, through different mechanisms such as broadspectrum β-lactamase production, overexpression of efflux pumps and reduction of pore permeability. Antimicrobial agents commonly used such as β-lactams and carbapenems are not effective against the emergence of resistant species. Thus, the study of new therapeutic approaches, such as the use of combined antimicrobials, bacteriophage therapies, and the development of new drugs, presents themselves as a possible solution to enhance therapy and to overcome the difficulties. To treat infections caused by A. baumannii, 11 new potentials antimicrobials are under study, three of which have recently obtained authorization from international organizations, omadacycline, cefiderocol and eravacycline. These antimicrobials have been shown in in vivo studies to be effective against these difficult-to-treat pathogens. Sulbactamdurlobactam and finafloxacin are also possible therapeutical options that are in advanced stages of development. However, most of the new antimicrobials under study are in the early stages of research and have yet to go a long way to clinical application, but they have good prospects of becoming effective drugs to fight infections caused by A. baumannii.