In Vitro Activity of Sulbactam-Durlobactam against Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates: A Multicentre Report from Italy

Bernardetta Segatore; Alessandra Piccirilli; Sabrina Cherubini; Luigi Principe; Giovanni Alloggia; Maria Lina Mezzatesta; Mario Salmeri; Stefano Di Bella; Roberta Migliavacca; Aurora Piazza; Elisa Meroni; Paolo Fazii; Daniela Visaggio; Paolo Visca; Venere Cortazzo; Giulia De Angelis; Arianna Pompilio; Mariagrazia Perilli

doi:10.3390/antibiotics11081136

In Vitro Activity of Sulbactam-Durlobactam against Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates: A Multicentre Report from Italy

Antibiotics (Basel). 2022 Aug 22;11(8):1136. doi: 10.3390/antibiotics11081136.

Authors

Bernardetta Segatore¹, Alessandra Piccirilli¹, Sabrina Cherubini¹, Luigi Principe², Giovanni Alloggia¹, Maria Lina Mezzatesta³, Mario Salmeri³, Stefano Di Bella⁴, Roberta Migliavacca⁵, Aurora Piazza⁵, Elisa Meroni⁶, Paolo Fazii⁷, Daniela Visaggio^{8

9}, Paolo Visca^{8

9}, Venere Cortazzo¹⁰, Giulia De Angelis¹⁰, Arianna Pompilio^{11

12}, Mariagrazia Perilli¹

Affiliations

¹ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
² Clinical Pathology and Microbiology Unit, "S. Giovanni di Dio" Hospital, 88900 Crotone, Italy.
³ Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95131 Catania, Italy.
⁴ Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy.
⁵ Unit of Microbiology and Clinical Microbiology, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
⁶ Clinical Microbiology and Virology Unit, "A. Manzoni" Hospital, 23900 Lecco, Italy.
⁷ Clinical Microbiology and Virology Unit, Spirito Santo Hospital, 65122 Pescara, Italy.
⁸ Department of Science, Roma Tre University, Viale G. Marconi 446, 00146 Rome, Italy.
⁹ Santa Lucia Foundation IRCCS, 00179 Rome, Italy.
¹⁰ Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
¹¹ Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.
¹² Center of Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.

Abstract

In the present study, the in vitro activity of the sulbactam-durlobactam (SUL-DUR) combination was evaluated against 141 carbapenem-resistant A. baumannii (CRAb) clinical strains collected from six Italian laboratories. Over half (54.6%) of these isolates were resistant to colistin. The SUL-DUR combination was active against these CRAb isolates with MIC₅₀ and MIC₉₀ values of 0.5 mg/L and 4 mg/L, respectively. Only eleven isolates were resistant to SUL-DUR with MIC values ranging from 8 to 128 mg/L. The SUL-DUR resistant A. baumannii exhibited several antimicrobial resistance genes (ARGs) such as bla_OXA-20, bla_OXA-58, bla_OXA-66, bla_ADC-25, aac(6')-Ib3 and aac(6')-Ib-cr and mutations in gyrA (S81L) and parC (V104I, D105E). However, in these isolates, mutations Q488K and Y528H were found in PBP3. Different determinants were also identified in these CRAb isolates, including adeABC, adeFGH, adeIJK, abeS, abaQ and abaR, which encode multidrug efflux pumps associated with resistance to multiple antibacterial agents. This is the first report on the antimicrobial activity of SUL-DUR against carbapenem-resistant A. baumannii isolates selected from multiple regions in Italy.

Keywords: A. baumannii; WGS; durlobactam.

Grants and funding

This research received no external funding.