{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:10:06Z","timestamp":1790741406411,"version":"4.1.0"},"reference-count":207,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea (NRF) funded by the Ministry of Education","award":["2022R1F1A1071415"],"award-info":[{"award-number":["2022R1F1A1071415"]}]},{"name":"National Research Foundation of Korea (NRF) funded by the Ministry of Education","award":["NRF-RS-2023-00275307"],"award-info":[{"award-number":["NRF-RS-2023-00275307"]}]},{"name":"National Research Foundation of Korea (NRF) funded by the Ministry of Education","award":["2019R1A6C1010033"],"award-info":[{"award-number":["2019R1A6C1010033"]}]},{"name":"Korea Basic Science Institute (National Research Facilities and Equipment Center) grant funded by the Ministry of Education","award":["2022R1F1A1071415"],"award-info":[{"award-number":["2022R1F1A1071415"]}]},{"name":"Korea Basic Science Institute (National Research Facilities and Equipment Center) grant funded by the Ministry of Education","award":["NRF-RS-2023-00275307"],"award-info":[{"award-number":["NRF-RS-2023-00275307"]}]},{"name":"Korea Basic Science Institute (National Research Facilities and Equipment Center) grant funded by the Ministry of Education","award":["2019R1A6C1010033"],"award-info":[{"award-number":["2019R1A6C1010033"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The emergence of antibiotic-resistant Acinetobacter baumannii (A. baumannii) is a pressing threat in clinical settings. Colistin is currently a widely used treatment for multidrug-resistant A. baumannii, serving as the last line of defense. However, reports of colistin-resistant strains of A. baumannii have emerged, underscoring the urgent need to develop alternative medications to combat these serious pathogens. To resist colistin, A. baumannii has developed several mechanisms. These include the loss of outer membrane lipopolysaccharides (LPSs) due to mutation of LPS biosynthetic genes, modification of lipid A (a constituent of LPSs) structure through the addition of phosphoethanolamine (PEtN) moieties to the lipid A component by overexpression of chromosomal pmrCAB operon genes and eptA gene, or acquisition of plasmid-encoded mcr genes through horizontal gene transfer. Other resistance mechanisms involve alterations of outer membrane permeability through porins, the expulsion of colistin by efflux pumps, and heteroresistance. In response to the rising threat of colistin-resistant A. baumannii, researchers have developed various treatment strategies, including antibiotic combination therapy, adjuvants to potentiate antibiotic activity, repurposing existing drugs, antimicrobial peptides, nanotechnology, photodynamic therapy, CRISPR\/Cas, and phage therapy. While many of these strategies have shown promise in vitro and in vivo, further clinical trials are necessary to ensure their efficacy and widen their clinical applications. Ongoing research is essential for identifying the most effective therapeutic strategies to manage colistin-resistant A. baumannii. This review explores the genetic mechanisms underlying colistin resistance and assesses potential treatment options for this challenging pathogen.<\/jats:p>","DOI":"10.3390\/pathogens13121049","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T02:57:08Z","timestamp":1732849028000},"page":"1049","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Colistin Resistance Mechanism and Management Strategies of Colistin-Resistant Acinetobacter baumannii Infections"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-3210","authenticated-orcid":false,"given":"Md Minarul","family":"Islam","sequence":"first","affiliation":[{"name":"Smart Animal Bio Institute, Dankook University, Cheonan 31116, Republic of Korea"},{"name":"Department of Microbiology, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da Eun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6292-4733","authenticated-orcid":false,"given":"Woo Shik","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH 44272, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man Hwan","family":"Oh","sequence":"additional","affiliation":[{"name":"Smart Animal Bio Institute, Dankook University, Cheonan 31116, Republic of Korea"},{"name":"Department of Microbiology, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea"},{"name":"Center for Bio-Medical Engineering Core Facility, Dankook University, Cheonan 31116, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jiang, M., Chen, X., Liu, S., Zhang, Z., Li, N., Dong, C., Zhang, L., Wu, H., and Zhao, S. 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