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Multidrug resistant (MDR)  Acinetobacter baumannii  poses a growing threat to global health. Research on  Acinetobacter  pathogenesis has primarily focused on pneumonia and bloodstream infections, even though one in five  A. baumannii  strains are isolated from urinary sites. In this study, we highlight the role of  A. baumannii  as a uropathogen. We develop the first  A. baumannii  catheter-associated urinary tract infection (CAUTI) murine model using UPAB1, a recent MDR urinary isolate. UPAB1 carries the plasmid pAB5, a member of the family of large conjugative plasmids that represses the type VI secretion system (T6SS) in multiple  Acinetobacter  strains. pAB5 confers niche specificity, as its carriage improves UPAB1 survival in a CAUTI model and decreases virulence in a pneumonia model. Comparative proteomic and transcriptomic analyses show that pAB5 regulates the expression of multiple chromosomally-encoded virulence factors besides T6SS. Our results demonstrate that plasmids can impact bacterial infections by controlling the expression of chromosomal genes.

Urinary tract colonization is enhanced by a plasmid that regulates uropathogenic Acinetobacter baumannii chromosomal genes