Abstract
Hospital-acquired pneumonia caused by Acinetobacter baumannii is a major healthcare burden. Type VI Secretion System (T6SS) contributes to both virulence and drug resistance in this bacteria. This study aims to investigate the diagnostic value of hemolysin co-regulated protein (Hcp) gene in A. baumannii pneumonia and further explore the effect of hcp on clinical, pathogenicity and drug resistance. 53 clinical A. baumannii strains from patients' respiratory tract at a teaching hospital were included in this study. Real-time quantitative polymerase chain reaction (qRT-PCR) was carried out to examine the expression of hcp. Recombinant Hcp expression plasmids (pET-28a(+)-hcp) were constructed and his-tagged Hcp were purified to stimulate Tohoku Hospital Pediatrics-1 (THP-1) macrophages. Nuclear Factor Kappa B p65 (NF-κBp65) and Interleukin 8 (IL-8) were detected by qRT-PCR. Antimicrobial susceptibility testing (AST) were examined by an automated instrument system. Hcp gene had 92.6% sensitivity and 75% specificity for distinguishing invasive or colonizing A. baumannii from the respiratory tract. His-tagged Hcp induced NF-κBp65 and IL-8 at gene level in THP-1 macrophages. Additional, high hcp expression isolates showed higher rate of antimicrobial agent exposure (< 30 days) of carbapenems, antibiotic combination therapy and multiple or extensive drug-resistant (MDR/XDR) and exhibited higher resistance rate to clinical commonly-used antimicrobial agents. Hcp gene could serve as a novel diagnostic biomarker to distinguish A. baumannii respiratory tract infection from colonization and participate in eliciting inflammatory responses in vitro. T6SS/hcp may play a role in the development of carbapenem-resistant A. baumannii (CRAB), multiple or extensive drug-resistant A. baumannii (MDRAB/XDRAB). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12088-023-01083-8.