title: Do biofilm formation and interactions with human cells explain the clinical success of Acinetobacter baumannii?
abstract: BACKGROUND
  The dramatic increase in antibiotic resistance and the recent manifestation in war trauma patients underscore the threat of Acinetobacter baumannii as a nosocomial pathogen. Despite numerous reports documenting its epidemicity, little is known about the pathogenicity of A. baumannii. The aim of this study was to obtain insight into the factors that might explain the clinical success of A. baumannii.
  
  
  RESULTS
  We compared biofilm formation, adherence to and inflammatory cytokine induction by human cells for a large panel of well-described strains of A. baumannii and compared these features to that of other, clinically less relevant Acinetobacter species. Results revealed that biofilm formation and adherence to airway epithelial cells varied widely within the various species, but did not differ among the species. However, airway epithelial cells and cultured human macrophages produced significantly less inflammatory cytokines upon exposure to A. baumannii strains than to strains of A. junii, a species infrequently causing infection.
  
  
  CONCLUSIONS
  The induction of a weak inflammatory response may provide a clue to the persistence of A. baumannii in patients.
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands. a.de_breij@lumc.nl
authors.forename: Anna
authors.initials: A
authors.lastname: de Breij
authors.forename: Lenie
authors.initials: L
authors.lastname: Dijkshoorn
authors.forename: Ellen
authors.initials: E
authors.lastname: Lagendijk
authors.forename: Joke
authors.initials: J
authors.lastname: van der Meer
authors.forename: Abraham
authors.initials: A
authors.lastname: Koster
authors.forename: Guido
authors.initials: G
authors.lastname: Bloemberg
authors.forename: Ron
authors.initials: R
authors.lastname: Wolterbeek
authors.forename: Peterhans
authors.initials: P
authors.lastname: van den Broek
authors.forename: Peter
authors.initials: P
authors.lastname: Nibbering
mesh_terms: D040981:Acinetobacter baumannii / Q000166:cytology* / Q000502:physiology* / Q000648:ultrastructure; D001422:Bacterial Adhesion; D018441:Biofilms / Q000254:growth & development*; D001980:Bronchi / Q000166:cytology; D002478:Cells, Cultured; D016207:Cytokines / Q000096:biosynthesis; D004847:Epithelial Cells / Q000166:cytology / Q000382:microbiology*; D006801:Humans; D008264:Macrophages / Q000378:metabolism / Q000382:microbiology; D013499:Surface Properties
chemical_list: D016207:Cytokines