Global spread of drug-resistant Acinetobacter baumannii in immunocompromised and cancer patients

<i>Acinetobacter baumannii</i> poses a severe threat in healthcare due to its highly adaptive genome and rapid spread of multidrug and extensively drug-resistant traits. Carbapenem resistance exceeds 70% in ICUs, with cancer patients showing even higher rates, including 94.1% of isolates carrying multiple carbapenemase genes such as OXA-23-like, NDM, and KPC. These strains, largely from International Clone II, exhibit strong virulence and environmental persistence. Immunocompromised patients face poor outcomes, with septicemia mortality reaching 49.5% and risk amplified by prolonged hospitalization, mechanical ventilation, invasive procedures, and prior carbapenem exposure. Limited therapeutic options, including toxic last-line colistin, further complicate management. Emerging AI-designed nano-vaccines offer promising preventive strategies for vulnerable populations.