Acinetobacterbaumannii-induced infective endocarditis: new insights into pathophysiology and antibiotic resistance mechanisms

Infective endocarditis (IE), characterized by inflammation of the endocardial surface of the heart and its valves, results from infections caused by Staphylococcus, Streptococcusand Acinetobacterspecies and less commonly fungi. Acinetobacter-induced IE is a relatively rare condition with significant morbidity and mortality worldwide. Notably, its mortality rate is greater than that of endocarditis induced by the Haemophilusspecies, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodensand Kingella kingae. Although it is rare, Acinetobacter-induced IE caused by A. baumanniimight bring unique therapeutic challenges such as increased antibiotic resistance. Therefore, it is vital to understand perfectly the possible pathophysiologic and antibiotic resistance mechanisms adopted by A. baumanniiduring IE. This review discusses the probable underlying pathomechanisms involved in A. baumannii-induced IE and highlights the potential antibiotic resistance mechanisms, suggesting therapeutic targets for A. baumannii-induced IE.