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Background   Acinetobacter baumannii  causes difficult-to-treat nosocomial infections, which often lead to morbidity due to the development of antimicrobial drug resistance and expression of virulence genes. Data regarding the association of resistance to colistin, a last treatment option, and the virulence gene expression of  A. baumannii  is scarce.    Methods  We evaluated the MLVA genotype, antimicrobial resistance, and biofilm formation of 100  A. baumannii  isolates from burn patients, and further compared the in vitro and in vivo expression of four virulence genes among five colistin-resistant  A. baumannii  (Cst-R-AB) isolates. Five Cst-R-AB isolates were tested; one from the present study, and four isolated previously.    Results  Our results showed that reduced expression of  recA , along with increased in vivo expression of  lpsB ,  dnaK , and  blsA ; are associated with colistin resistance among Cst-R-AB isolates. Differences in virulence gene expressions among Cst-R-AB isolates, may in part explain common discrepant in vitro vs. in vivo susceptibility data during treatment of infections caused by Cst-R-AB.    Conclusions  Our findings highlight the intricate relationship between colistin-resistance and virulence among  A. baumannii  isolates, and underscore the importance of examining the interactions between virulence and antimicrobial resistance toward efforts to control the spread of multidrug-resistant  A. baumannii  (MDR-AB) isolates, and also to reduce disease severity in burn patients with MDR-AB infection.    Electronic supplementary material  The online version of this article (10.1186/s12941-018-0277-6) contains supplementary material, which is available to authorized users.

annals of clinical microbiology and antimicrobials

Association of virulence gene expression with colistin-resistance in Acinetobacter baumannii: analysis of genotype, antimicrobial susceptibility, and biofilm formation