Current and novel therapies for management of Acinetobacter baumannii-associated pneumonia

Aye Mya Sithu Shein; Parichart Hongsing; O'Rorke Kevin Smith; Phatthranit Phattharapornjaroen; Kazuhiko Miyanaga; Longzhu Cui; Hitoshi Ishikawa; Mohan Amarasiri; Peter N Monk; Anthony Kicic; Tanittha Chatsuwan; Daniel Pletzer; Paul G Higgins; Shuichi Abe; Dhammika Leshan Wannigama

doi:10.1080/1040841X.2024.2369948

Current and novel therapies for management of Acinetobacter baumannii-associated pneumonia

Crit Rev Microbiol. 2024 Jul 1:1-22. doi: 10.1080/1040841X.2024.2369948. Online ahead of print.

Authors

Aye Mya Sithu Shein^{1

2}, Parichart Hongsing^{3

4}, O'Rorke Kevin Smith⁵, Phatthranit Phattharapornjaroen^{6

7}, Kazuhiko Miyanaga⁸, Longzhu Cui⁸, Hitoshi Ishikawa⁹, Mohan Amarasiri¹⁰, Peter N Monk¹¹, Anthony Kicic^{12

13

14

15}, Tanittha Chatsuwan^{1

2}, Daniel Pletzer⁵, Paul G Higgins^{16

17

18}, Shuichi Abe¹⁹, Dhammika Leshan Wannigama^{1

2

19

20

21

22}

Affiliations

¹ Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
² Center of Excellence in, Antimicrobial Resistance and Stewardship Research, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
³ Mae Fah Luang University Hospital, Chiang Rai, Thailand.
⁴ School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand.
⁵ Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand.
⁶ Department of Emergency Medicine, Center of Excellence, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
⁷ Department of Surgery, Sahlgrenska Academy, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden.
⁸ Division of Bacteriology, School of Medicine, Jichi Medical University, Tochigi, Japan.
⁹ Yamagata Prefectural University of Health Sciences, Kamiyanagi, Japan.
¹⁰ Laboratory of Environmental Hygiene, Department of Health Science, School of Allied Health Sciences, Kitasato University, Kitasato, Sagamihara-Minami, Japan.
¹¹ Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield Medical School, UK.
¹² Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia.
¹³ Centre for Cell Therapy and Regenerative Medicine, Medical School, The University of Western Australia, Nedlands, Western Australia, Australia.
¹⁴ Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, Western Australia, Australia.
¹⁵ School of Population Health, Curtin University, Bentley, Western Australia, Australia.
¹⁶ Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany.
¹⁷ German Centre for Infection Research, Partner site Bonn-Cologne, Cologne, Germany.
¹⁸ Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
¹⁹ Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan.
²⁰ School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia.
²¹ Biofilms and Antimicrobial Resistance Consortium of ODA receiving countries, The University of Sheffield, Sheffield, UK.
²² Pathogen Hunter's Research Team, Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan.

PMID: 38949254
DOI: 10.1080/1040841X.2024.2369948

Abstract

Acinetobacter baumannii is a common pathogen associated with hospital-acquired pneumonia showing increased resistance to carbapenem and colistin antibiotics nowadays. Infections with A. baumannii cause high patient fatalities due to their capability to evade current antimicrobial therapies, emphasizing the urgency of developing viable therapeutics to treat A. baumannii-associated pneumonia. In this review, we explore current and novel therapeutic options for overcoming therapeutic failure when dealing with A. baumannii-associated pneumonia. Among them, antibiotic combination therapy administering several drugs simultaneously or alternately, is one promising approach for optimizing therapeutic success. However, it has been associated with inconsistent and inconclusive therapeutic outcomes across different studies. Therefore, it is critical to undertake additional clinical trials to ascertain the clinical effectiveness of different antibiotic combinations. We also discuss the prospective roles of novel antimicrobial therapies including antimicrobial peptides, bacteriophage-based therapy, repurposed drugs, naturally-occurring compounds, nanoparticle-based therapy, anti-virulence strategies, immunotherapy, photodynamic and sonodynamic therapy, for utilizing them as additional alternative therapy while tackling A. baumannii-associated pneumonia. Importantly, these innovative therapies further require pharmacokinetic and pharmacodynamic evaluation for safety, stability, immunogenicity, toxicity, and tolerability before they can be clinically approved as an alternative rescue therapy for A. baumannii-associated pulmonary infections.

Keywords: Acinetobacter baumannii; Acinetobacter baumannii-associated pneumonia; current antimicrobial therapies; hospital-acquired pneumonia; novel therapies.

Publication types

Review