1. Wprowadzenie. 2. Oporność pałeczek Acinetobacter spp. na aminoglikozydy. 3. Oporność pałeczek Acinetobacter spp. na tetracykliny. 4. Oporność pałeczek Acinetobacter spp. na fluorochinolony. 5. Oporność Acinetobacter spp. na sulfonamidy i trimetoprim. 6. Oporność Acinetobacter spp. na chloramfenikol. 7. Zastosowanie kolistyny w zakażeniach pałeczkami Acinetobacter spp. 8. Antybiotykoterapia złożona w leczeniu zakażeń Acinetobacter spp. 9. Podsumowanie

Abstract: In recent years Acinetobacter spp. have emerged as important nosocomial pathogens which are known to express a variety of resistance mechanisms. They do not posses any important virulence factors. The danger of these agents resides in their capability to acquire and develop resistance to multiple classes of useful antibiotics to the extent that it could be considered as a significant virulence factor. In this way, they can adapt to new environmental conditions. It is important to know the mechanisms of resistance to non-b-lactam antibiotics because some of Acinetobacter spp. exhibit resistance to all b-lactams, including carbapenems, and reduced susceptibility to polymyxins.
   Apart from b-lactams, aminoglycosides fluoroquinolones and tetracyclines are widely used for treating Acinetobacter spp. infections. Acinetobacter spp. resistance to aminoglycosides results from the production of aminoglycoside -modifying enzymes such as acetyltransferases (AAC), nucleotidyltransferases (ANT, AAD) and phosphotransferases (APH). Resistance to fluoroquinolones has been linked to mutations in the quinolone-resistance-determining-region (QRDR) of gyrA, parC genes and a decrease in quinolone accumulation due to the decreased uptake or increased efflux. The main mechanisms responsible for tetracycline resistance have been identified as the expression of efflux pumps tet(A), tet(B) and ribosomal protection (tetM).
    Combination therapy is used to widen the antymicrobial spectrum, minimize toxicity and prevent the emergence of resistant mutants.

1. Introduction. 2. Resistance of Acinetobacter spp. to aminoglycosides. 3. Resistance of Acinetobacter spp to tetracyclines. 4. Resistance of Acinetobacter spp. to fluoroquinolones. 5. Resistance of Acinetobacter spp. to sulfamethoxazole-trimethoprim. 6. Resistance of Acinetobacter spp to chloramphenikol. 7. Use of colistin in infections caused by Acinetobacter spp. 8. Combination therapy in infections caused by Acinetobacter spp. 9. Summary