Outer membrane vesicles of carbapenem-resistant Acinetobacter baumannii derive enhanced inflammatory response

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a critical nosocomial pathogen with limited treatment options. Although antibiotic resistance in CRAB is well-characterized, its interactions with host immunity and the contribution of outer membrane vesicles (OMVs) to pathogenesis remain poorly understood. We examined a clinical CRAB isolate and compared it with the reference strain A19606. Antimicrobial susceptibility testing revealed complete resistance of CRAB to commonly used antibiotics in clinical practice, while A19606 remained susceptible to most agents. In murine intranasal infection models and bone marrow-derived macrophages, CRAB induced significantly stronger activation of inflammatory signaling pathways and elevated levels of pro-inflammatory cytokines relative to A19606. Transcriptomic analysis of infected lung tissue identified differentially expressed genes, enriched for inflammatory response pathways. proteomics showed upregulated proteins in CRAB related to secretion systems. OMVs characterization revealed that CRAB-derived OMVs highly enriched in proteins associated with periplasmic and outer membrane spaces, and more potent in triggering macrophage inflammatory signaling. CRAB displays expansive antibiotic resistance and enhanced pro-inflammatory potential mediated in part by unique OMVs properties. Targeting OMVs formation or host immune modulation may represent effective strategies for combating CRAB infections.