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Review
. 2022 Dec 10;11(12):1793.
doi: 10.3390/antibiotics11121793.

Acinetobacter baumannii Resistance to Sulbactam/Durlobactam: A Systematic Review

Luigi Principe  1 , Stefano Di Bella  2 , Jacopo Conti  3 , Mariagrazia Perilli  4 , Alessandra Piccirilli  4 , Cristina Mussini  3 , Giuliana Decorti  2   5
Affiliations
Review

Acinetobacter baumannii Resistance to Sulbactam/Durlobactam: A Systematic Review

Luigi Principe et al. Antibiotics (Basel). .

Abstract

Infections caused by carbapenem-resistant Acinetobacter baumannii (CRAB) have limited therapeutic options. Sulbactam-durlobactam is a combination of two βlactamase inhibitors with activity against CRAB under phase 3 clinical investigation. We performed a systematic review on in vitro studies reporting A. baumannii resistances against sulbactam/durlobactam. We considered "resistant" species to be those with MIC ≥ 8 mg/L. Ten studies were included in the review (9754 tested isolates). Overall, 2.3% of A. baumannii were resistant to sulbactam/durlobactam, and this percentage rose to 3.4% among CRAB subgroups and to 3.7% among colistin-resistant strains. Resistance was 100% among metallo β-lactamase-producing strains. Overall, in 12.5% of cases, sulbactam/durlobactam resistance was associated with the production of NDM-1, in 31.7% of cases with the substitutions in the PBP3 determinants, and in the remaining cases the resistance mechanism was unknown. In conclusion, A. baumannii resistance towards sulbactam/durlobactam is limited, except for MBL-producing strains.

Keywords: Acinetobacter; efficacy; resistance; resistances; sulbactam-durlobactam; sulbactam/durlobactam; susceptibility.

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Conflict of interest statement

The authors declare no conflict of interest.

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