Insights into Acinetobacter War-Wound Infections, Biofilms, and Control

OBJECTIVE: Multidrug-resistant Acinetobacter baumannii is associated with a wide spectrum of infectious diseases ranging from nosocomial, community-acquired infections to those acquired following war or natural disaster. Especially to military personnel with war wounds, Acinetobacter infection is a formidable threat. The treatment has become exceedingly difficult, not only because the bacterium can develop extensive antimicrobial resistance but because it also forms biofilms that are resistant to host defense and antimicrobial treatment. Such causative factors as biofilm formation and resistance are highly likely to lead to nonhealing wounds. This review, although focused on A baumannii infections, aims to summarize what is known about immunization protection against wound biofilm infections and to apply such understanding in exploring the unknown area of war-wound infection protection. DATA SOURCES AND STUDY SELECTION: Publications were searched and selected through http://www.pubmed.gov by using the key words Acinetobacter baumannii, bacteria, war wounds, burn wounds, wound infections, biofilms, vaccines, and immunization. The literature selected was categorized according to the subheadings within this article. CONCLUSIONS: It is imperative to develop such effective measures as active and passive immunization to control multidrug-resistant and tenacious A baumannii infections and to prevent nonhealing wounds. The authors' understanding in immunization against burn wound-related infections by the model bacteria will facilitate research progress in the poorly explored area of immunization against war-wound biofilm infections.