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Although phages have shown promising results in treating bacterial infections, the mechanisms of the combined effect of phages and innate immunity on clearing\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    remain unclear. Here, we report a synergistic effect of the complement system and phages on clearing multidrug-resistant\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    . We show that\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    rapidly adapts and becomes resistant to phage or serum complement by modifying the expression of capsule and lipooligosaccharides, which can be regulated through reversible transposon mutagenesis in the K locus. Compared to the encapsulated phenotype, the non-encapsulated, phage-resistant\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    showed a higher level of membrane attack complex deposition and were susceptible to killing by complement. In contrast, the encapsulated phenotype escaped the complement system by shedding the membrane attack complex to the environment. Thus, while the complement system targets the non-encapsulated phenotype, the phage infects and eliminates the encapsulated subpopulation. These results suggest means of combatting antibiotic-resistant\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    by a simultaneous treatment with phages and complement, a combination which can be supplemented further with antibacterial antibodies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s00430-025-00852-0","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T08:53:00Z","timestamp":1756803180000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Antibiotic-resistant Acinetobacter baumannii can be killed by a combination of bacteriophages and complement"],"prefix":"10.1007","volume":"214","author":[{"given":"Carmen","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Krzy\u017cewska-Dudek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheetal","family":"Patpatia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinaya","family":"Dulipati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Natalia","family":"Mapelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aycan","family":"Meral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Kotimaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saija","family":"Kiljunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seppo","family":"Meri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"852_CR1","first-page":"348","volume":"43","author":"E Tacconelli","year":"2017","unstructured":"Tacconelli E, Magrini N (2017) Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. 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