Acinetobacter baumannii Biofilm: Intervening Factors, Persistence, Drug Resistance, and Strategies of Treatment

Acinetobacter baumannii (A. baumannii) is a Gram-negative opportunistic and nosocomial pathogen that is associated with most of the hospital epidemics. Its success can be directly attributed to its ability to survive under stressful hospital conditions (desiccation, nutrient starvation, and antimicrobial treatments). This survival ability results from the capacity of A. baumannii to form biofilms on the abiotic (polystyrene and glass) and biotic surfaces (epithelial cells and fungal filaments). The purpose of this review is to report different factors implicated in the biofilm formation of A. baumannii, notably biofilm-associated protein, CsuA/BABCD chaperone-usher pili system, poly-beta-1,6-N-acetylglucosamine, outer membrane protein A, quorum sensing, surface properties, and growing conditions. This review will also discuss the relationship between biofilm formation and multidrug resistance, in addition to several strategies that can be useful in the prevention and treatment of A. baumannii biofilm.