Principe Luigi, Di Bella Stefano, Conti Jacopo, Perilli Mariagrazia, Piccirilli Alessandra, Mussini Cristina, Decorti Giuliana
Clinical Pathology and Microbiology Unit, "San Giovanni di Dio" Hospital, 88900 Crotone, Italy.
Clinical University Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy.
Antibiotics (Basel). 2022 Dec 10;11(12):1793. doi: 10.3390/antibiotics11121793.
Infections caused by carbapenem-resistant (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 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 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, resistance towards sulbactam/durlobactam is limited, except for MBL-producing strains.
耐碳青霉烯类鲍曼不动杆菌(CRAB)引起的感染治疗选择有限。舒巴坦-度洛巴坦是两种β-内酰胺酶抑制剂的组合,正在进行3期临床研究,对CRAB具有活性。我们对报告对舒巴坦/度洛巴坦耐药性的体外研究进行了系统评价。我们将“耐药”菌株定义为那些MIC≥8mg/L的菌株。该评价纳入了10项研究(共检测9754株分离株)。总体而言,2.3%的菌株对舒巴坦/度洛巴坦耐药,在CRAB亚组中这一比例升至3.4%,在耐黏菌素菌株中升至3.7%。产金属β-内酰胺酶的菌株耐药率为100%。总体而言,在12.5%的病例中,舒巴坦/度洛巴坦耐药与NDM-1产生有关,在31.7%的病例中与PBP3决定簇的替换有关,其余病例的耐药机制尚不清楚。总之,除产MBL的菌株外,对舒巴坦/度洛巴坦的耐药性有限。