Carbapenem-Resistant Acinetobacter baumannii: From Molecular Mechanisms to Clinical Practice

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: closed (31 December 2025) | Viewed by 2143

Special Issue Editors


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Guest Editor
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
Interests: clinical assessment; infectious disease treatment; MDR bacteria; emerging and tropical infectious diseases
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Guest Editor
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
Interests: clinical trials; molecular and clinical epidemiology of infections

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Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
Interests: antimicrobial stewardship; MDR; HIV; MPOX; STIs

Special Issue Information

Dear Colleagues,

Acinetobacter baumannii has emerged as one of the most challenging multidrug-resistant pathogens in healthcare settings worldwide. In particular, carbapenem-resistant A. baumannii (CRAB) poses a serious threat due to its ability to acquire and disseminate resistance determinants, survive in harsh environments, and cause severe infections in vulnerable patients. The rise of CRAB has led to limited therapeutic options and increased morbidity and mortality, especially in intensive care units.

This Special Issue aims at exploring CRAB from a multidisciplinary perspective, ranging from molecular resistance mechanisms, genomic surveillance, and epidemiology to infection control strategies, clinical management, and novel therapeutic approaches. We invite original research articles, reviews, and case reports, that contribute to a deeper understanding of CRAB and support evidence-based clinical practice.

Prof. Dr. Antonio Cascio
Prof. Dr. David L. Paterson
Guest Editors

Dr. Luca Pipitò
Guest Editor Assistant

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Keywords

  • CRAB
  • XDR
  • MDR
  • Acinetobacter baumannii
  • antimicrobial resistance
  • molecular mechanisms
  • clinical practice

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Published Papers (1 paper)

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12 pages, 2766 KB  
Case Report
Eravacycline as Salvage Therapy for Severe Intra-Abdominal Infections Caused by Multidrug-Resistant Acinetobacter baumannii: A Case Series
by Marcello Trizzino, Giulio D’Agati, Luca Pipitò, Claudia Conti, Rossella Petrantoni, Raffaella Rubino, Antonio Anastasia, Sofia Urso, Irene Ganci, Maria Cappello and Antonio Cascio
Antibiotics 2026, 15(1), 93; https://doi.org/10.3390/antibiotics15010093 - 16 Jan 2026
Cited by 1 | Viewed by 1236
Abstract
Background/Objectives: Infections due to multidrug-resistant (MDR) Acinetobacter baumannii represent a critical challenge in modern healthcare, with limited therapeutic options. Eravacycline, a novel fluorocycline antibiotic, demonstrates promising in vitro activity, but real-world clinical data for complex intra-abdominal infections (IAIs) are scarce. We present [...] Read more.
Background/Objectives: Infections due to multidrug-resistant (MDR) Acinetobacter baumannii represent a critical challenge in modern healthcare, with limited therapeutic options. Eravacycline, a novel fluorocycline antibiotic, demonstrates promising in vitro activity, but real-world clinical data for complex intra-abdominal infections (IAIs) are scarce. We present two cases of severe IAI caused by carbapenem-resistant A. baumannii (CRAB) successfully treated with eravacycline. Methods: We describe the clinical course, microbiological findings, and outcomes of two critically ill patients. Case 1 was a 75-year-old male with biliary peritonitis following an endoscopic procedure. Case 2 was a 64-year-old male with infected pancreatic walled-off necrosis. Both patients had cultures positive for CRAB and failed multiple prior antibiotic regimens. Results: In both cases, the initiation of intravenous eravacycline led to significant clinical improvement, including resolution of septic shock and defervescence. A marked reduction in inflammatory markers (C-reactive protein and procalcitonin) was observed, alongside microbiological clearance of CRAB. Eravacycline was well tolerated, with no significant adverse events. Conclusions: These case reports suggest that eravacycline can be an effective and safe salvage therapy for complex IAIs caused by CRAB, even in scenarios of partial source control. It represents a valuable addition to the antimicrobial armamentarium for managing infections caused by these extensively drug-resistant organisms. Full article
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