%0 Journal Article
%T Acinetobacter baumannii Resistance to Sulbactam/Durlobactam: A Systematic Review.
%A Principe L
%A Di Bella S
%A Conti J
%A Perilli M
%A Piccirilli A
%A Mussini C
%A Decorti G
%J Antibiotics (Basel)
%V 11
%N 12
%D Dec 2022 10
%M 36551450
%F 5.222
%R 10.3390/antibiotics11121793
%X 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.