Infectious diseases (London, England) · 2025
In vitro activity of cefiderocol and sulbactam-durlobactam against carbapenem-resistant Acinetobacter baumannii clinical isolates collected between 2019 and 2024.
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Palavecino Elizabeth L, Kilic Abdullah
Аннотация
BACKGROUND: The management of Acinetobacter baumannii infections has become increasingly challenging due to extensive antimicrobial resistance.
OBJECTIVES: This study evaluated the in vitro activity of cefiderocol and sulbactam-durlobactam and characterised OXA-type enzyme diversity in carbapenem-resistant A. baumannii isolates collected between March 2019 and December 2024.
METHODS: A total of 159 unique carbapenem-resistant isolates were tested for susceptibility to cefiderocol and sulbactam-durlobactam using two Food and Drug Administration-cleared minimum inhibitory concentration (MIC) determination methods: the ComASP Cefiderocol panel (Liofilchem, Italy) for cefiderocol and Etest strips (bioMérieux, USA) for sulbactam-durlobactam. Carbapenemase genes, including blaNDM, blaKPC, blaIMP, blaVIM, blaOXA-23, blaOXA-24/40, blaOXA-48, and blaOXA-58, were detected using real-time PCR.
RESULTS: Cefiderocol susceptibility was observed in 91.8% of isolates, with MIC50 and MIC90 values of 0.5 mg/L and 2 mg/L. Among blaOXA-23-positive isolates, MIC50 and MIC90 values were also 0.5 mg/L and 2 mg/L, while blaOXA-24/40-positive isolates showed MIC50 and MIC90 values of 0.25 mg/L and 1 mg/L, respectively. The sulbactam-durlobactam combination demonstrated potent in vitro activity against 97.5% of carbapenem-resistant Acinetobacter baumannii clinical isolates, with MIC50 and MIC90 values of 2 mg/L and 4 mg/L, respectively. Among the 159 carbapenem-resistant Acinetobacter baumannii isolates, 72.9% (n = 116) carried the blaOXA-23 gene, 10.7% (n = 17) harboured blaOXA-24/40, and 16.4% (n = 26) did not possess any of the carbapenemase genes included in the testing panel.
CONCLUSION: Cefiderocol and sulbactam-durlobactam exhibited strong in vitro activity against carbapenem-resistant A. baumannii isolates from a single University Hospital and may represent valuable treatment options for patients with limited therapeutic alternatives.
OBJECTIVES: This study evaluated the in vitro activity of cefiderocol and sulbactam-durlobactam and characterised OXA-type enzyme diversity in carbapenem-resistant A. baumannii isolates collected between March 2019 and December 2024.
METHODS: A total of 159 unique carbapenem-resistant isolates were tested for susceptibility to cefiderocol and sulbactam-durlobactam using two Food and Drug Administration-cleared minimum inhibitory concentration (MIC) determination methods: the ComASP Cefiderocol panel (Liofilchem, Italy) for cefiderocol and Etest strips (bioMérieux, USA) for sulbactam-durlobactam. Carbapenemase genes, including blaNDM, blaKPC, blaIMP, blaVIM, blaOXA-23, blaOXA-24/40, blaOXA-48, and blaOXA-58, were detected using real-time PCR.
RESULTS: Cefiderocol susceptibility was observed in 91.8% of isolates, with MIC50 and MIC90 values of 0.5 mg/L and 2 mg/L. Among blaOXA-23-positive isolates, MIC50 and MIC90 values were also 0.5 mg/L and 2 mg/L, while blaOXA-24/40-positive isolates showed MIC50 and MIC90 values of 0.25 mg/L and 1 mg/L, respectively. The sulbactam-durlobactam combination demonstrated potent in vitro activity against 97.5% of carbapenem-resistant Acinetobacter baumannii clinical isolates, with MIC50 and MIC90 values of 2 mg/L and 4 mg/L, respectively. Among the 159 carbapenem-resistant Acinetobacter baumannii isolates, 72.9% (n = 116) carried the blaOXA-23 gene, 10.7% (n = 17) harboured blaOXA-24/40, and 16.4% (n = 26) did not possess any of the carbapenemase genes included in the testing panel.
CONCLUSION: Cefiderocol and sulbactam-durlobactam exhibited strong in vitro activity against carbapenem-resistant A. baumannii isolates from a single University Hospital and may represent valuable treatment options for patients with limited therapeutic alternatives.