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.
摘要：
耐碳青霉烯类鲍曼不动杆菌（CRAB）引起的感染的治疗选择有限。舒巴坦-杜洛巴坦是两种β内酰胺酶抑制剂的组合，在3期临床研究中具有抗CRAB的活性。我们对报告鲍曼不动杆菌对舒巴坦/杜洛巴坦的耐药性的体外研究进行了系统评价。我们认为“抗性”物种是MIC≥8mg/L的物种。该综述包括10项研究(9754个测试的分离株)。总的来说,2.3％的鲍曼不动杆菌对舒巴坦/杜洛巴坦耐药，在CRAB亚组中，这一百分比上升到3.4％，在粘菌素耐药菌株中上升到3.7％。产金属β-内酰胺酶菌株的抗性为100%。总的来说,在12.5%的案例中，舒巴坦/durlobactam抗性与NDM-1的产生有关，在31.7％的病例中，PBP3决定簇中存在取代，在其余病例中，耐药机制未知。总之,鲍曼不动杆菌对舒巴坦/杜洛巴坦的耐药性有限，除了生产MBL的菌株。
