Relación entre virulencia y resistencia antimicrobiana en Acinetobacter baumannii
Relación entre virulencia y resistencia antimicrobiana en Acinetobacter baumannii
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Acinetobacter baumanni causa frecuentemente infecciones intrahospitalarias y actualmente se ha relacionado con el desarrollo de infecciones severas adquiridas en la comunidad. La capacidad de colonizar diversos hábitats y la versatilidad en su metabolismo ha influido en el incremento del número de infecciones nosocomiales, siendo responsable del desarrollo de enfermedades como: sepsis, neumonías y meningitis. Estas infecciones aparecen en forma de brotes, dominados por clones epidémicos con multirresistencia a los antibióticos que causan altas tasas de morbilidad y mortalidad. Las Unidades de Cuidados Intensivos son las más afectadas por el uso masivo de antibióticos que ocasiona la aparición de cepas multirresistentes. Es importante estudiar los mecanismos de patogénesis y la resistencia a los antibióticos, como factores directos que determinan el problema de salud.
Por otra parte, las islas de patogenecidad que corresponde a material genético exógeno que ha sido integrado al genoma de la bacteria, explicaría en gran medida el carácter patogénico de la bacteria. Estas transportan genes que confieren multirresistencia a los antibióticos y son responsables directos de llevar genes involucrados en mecanismos patogénicos como son: el sistema de captación de hierro, el sistema para la formación de biopelículas en superficies abióticas, el mecanismo de formación de la proteína de membrana externa 38 y los sistemas de secreción de proteínas tipo IV, que han sido demostrados como responsables directos de la patogénesis de diversos patógenos. En este artículo se revisa la situación actual de la incidencia de las infecciones nosocomiales causadas por A. baumannii multirresistente a los antibióticos, los principales mecanismos de resistencia a fármacos y la asociación de ésta con los mecanismos de patogenicidad. El conocimiento de los elementos involucrados en la patogénesis de A. baumannii permitirá establecer los mecanismos que lleven a controlar su diseminación.
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- DOI: http://dx.doi.org/10.22490/24629448.455 .