Infection and Drug Resistance最新文献

{"title":"High Prevalence of ESBL-Producing Enterobacteriaceae and Antimicrobial Resistance Patterns in a Tertiary Care Hospital in Mogadishu, Somalia: A Retrospective Cross-Sectional Study.","authors":"Liban Abdi Nor, Ahmed Hassan Ibrahim, Serpil Doğan, Hanan Hassan Hirei, Said Mohamed Mohamud, Abdulrahman Nor Abdi, Yahye Sheikh Abdulle Hassan","doi":"10.2147/IDR.S630945","DOIUrl":"10.2147/IDR.S630945","url":null,"abstract":"<p><strong>Background: </strong>Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are a major global public health threat because of resistance to third-generation cephalosporins and frequent multidrug resistance. Data from Somalia remain limited. This study determined the prevalence of ESBL production, antimicrobial resistance patterns, and associated clinical and demographic factors.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted on 369 non-duplicate clinical Enterobacteriaceae isolates collected from inpatient and outpatient departments of a tertiary care hospital in Mogadishu, Somalia, between April and December 2025. ESBL production was detected using the combination disc test according to Clinical Laboratory Standards Institute (CLSI) guidelines. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and E-test. Multidrug resistance (MDR) was defined as resistance to at least one agent in three or more antimicrobial classes. Associations were assessed using Pearson's chi-square test.</p><p><strong>Results: </strong>Overall, 71.27% (263/369) of isolates were ESBL producers and 48.78% (180/369) were MDR. <i>Escherichia coli</i> (59.35%) was the predominant isolate, followed by <i>Klebsiella</i> spp. (30.62%) and <i>Enterobacter</i> spp. (5.15%). High resistance (>68%) to third- and fourth-generation cephalosporins was observed across major species. Meropenem resistance was highest in <i>Enterobacter</i> spp. (63.16%). Hospital department was significantly associated with ESBL production (p = 0.003) and MDR (p = 0.004), with the highest burden in the intensive care unit. Gender was associated with ESBL production (p = 0.034), while organism type was associated with MDR (p = 0.044).</p><p><strong>Conclusion: </strong>The high prevalence of ESBL-producing and multidrug-resistant Enterobacteriaceae, particularly in intensive care settings, highlights the need for strengthened antimicrobial stewardship, enhanced infection prevention and control, and continuous antimicrobial resistance surveillance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"630945"},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Virological Outcomes of a Modified Albuvirtide Intensification Regimen with Standard ART in People with HIV.","authors":"Caiqin Hu, Xiaotang Zhou, Lingling He, Xueling Zhu, Qing Cao, Bohao Dai, Junwei Su, Huiting Liu, Jiaying Qin, Jingjing Wang, Biao Zhu","doi":"10.2147/IDR.S617345","DOIUrl":"10.2147/IDR.S617345","url":null,"abstract":"<p><strong>Background: </strong>To control HIV-1 viral load and maintain optimal immune function, albuvirtide (ABT) combined with antiretroviral therapy (ART) is used in designated AIDS hospitals in China. However, the standard weekly 320-mg ABT injection regimen poses adherence-related challenges. This study explored the safety and virological outcomes of a modified ABT intensification regimen in people with HIV.</p><p><strong>Methods: </strong>This single-arm, uncontrolled prospective cohort enrolled 20 people with HIV who received intravenous ABT 320 mg for three consecutive days every four weeks while continuing their baseline ART regimens. Peripheral blood samples were collected to measure alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TAG), cholesterol, CD4⁺ T-cell counts, HIV-RNA levels, and plasma ABT concentrations.</p><p><strong>Results: </strong>No adverse events considered related to ABT were observed in this cohort. Pharmacokinetic analysis demonstrated sustained therapeutic exposure, with mean trough concentrations of 4.71 mg/L, 3.83 mg/L, and 4.53 mg/L at Weeks 4, 8, and 12, respectively, each exceeding 50-fold the IC₉ ₀. During follow-up, mean HIV-RNA decreased from 1.65 log₁₀ copies/mL at baseline to 0.59 log₁₀ copies/mL at Week 12 (mean reduction: 1.06 log₁ ₀ copies/mL; <i>P</i> = 0.0007). Among patients with baseline HIV-RNA above 20 copies/mL, the viral load decreased from 2.55 to 1.43 log₁₀ copies/mL.</p><p><strong>Conclusion: </strong>Preliminary results demonstrate that 4-week ABT antiviral intensification regimen is feasible and exhibits potential antiviral activity.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"617345"},"PeriodicalIF":3.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Antimicrobial Resistance Genes and Clonal Relatedness of Outbreak-Associated <i>Salmonella</i> Enteritidis Isolates Using PFGE.","authors":"Farhad Nikkhahi, Fatemeh Zeynali Kelishomi, Mohammad Mehdi Soltan Dallal, Anita Fardsanei, Fatemeh Fardsanei","doi":"10.2147/IDR.S635566","DOIUrl":"10.2147/IDR.S635566","url":null,"abstract":"<p><strong>Purpose: </strong><i>Salmonella</i> Enteritidis is one of the most common causes of gastroenteritis outbreaks. Detailed characterization of outbreak-associated isolates is essential for understanding local epidemiology, antimicrobial resistance patterns, and transmission dynamics. Epidemiological investigations of these strains can help to control the spread of this bacterium.</p><p><strong>Methods: </strong>In the current study, 27 strains of <i>S</i>. Enteritidis were isolated from patients with gastroenteritis. Antibiotic resistance of these strains was determined using phenotypic and genotypic methods. Biofilm formation ability was evaluated using the microtiter method. The strains were clustered using pulsed-field gel electrophoresis (PFGE) with <i>Avr</i>II.</p><p><strong>Results: </strong>The highest rate of antibiotic resistance was associated with cefuroxime (74.1%). Five antibiotic-resistance genes were detected, and all of them were <i>bla</i> _TEM. Of 27 strains, 96.3% were biofilm producers. According to PFGE results, the studied strains were all included in one clone.</p><p><strong>Conclusion: </strong>This study provides data on the antimicrobial susceptibility and high biofilm-forming capacity of outbreak-associated <i>S</i>. Enteritidis isolates in Iran. The limited genetic diversity observed by PFGE highlights the clonal nature of these strains and suggests that combining PFGE with additional DNA-based methods is beneficial for an accurate diagnosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"635566"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Resistance Profiles of Bacterial Isolates from Purulent Specimens in Women and Children: A Six-Year Retrospective Study in Central China.","authors":"Sijing Liu, Meng Ye, Lei Xi, Bangxian Ding, Yijian Zhou","doi":"10.2147/IDR.S632047","DOIUrl":"10.2147/IDR.S632047","url":null,"abstract":"<p><strong>Objective: </strong>To analyze pathogenic distribution, temporal trends, age-specific differences, and antimicrobial resistance (AMR) profiles of purulent specimens from a Central China women-and-children hospital, to guide empirical antimicrobial therapy and stewardship.</p><p><strong>Methods: </strong>This single-center, retrospective study included 6767 purulent specimens (including wound exudates, abscess pus and surgical site secretions, among others) collected between 2019 and 2024 at a tertiary hospital in Central China. Bacterial identification and AMR testing followed CLSI standards; data were analyzed <i>via</i> WHONET 5.6 and GraphPad Prism.</p><p><strong>Results: </strong>4,676 (69.1%, N=6,767) strains were isolated. <i>Escherichia coli</i> (33.2%) and <i>Staphylococcus aureus</i> (19.7%) were predominant. Distinct age-specific spectra were observed, along with an apparent increase in the isolation rate of <i>Pseudomonas aeruginosa</i> over the study period. <i>Escherichia coli</i> exhibited the highest resistance rates, particularly to ampicillin (79.9%), and <i>Staphylococcus aureus</i> to penicillin G (95.4%), while carbapenems and amikacin retained high <i>in</i> <i>vitro</i> activity against the major Gram-negative isolates.</p><p><strong>Conclusion: </strong>Purulent infections present age-specific pathogenic spectra. <i>E. coli</i> and <i>S. aureus</i> are core pathogens; the observed increase in <i>P. aeruginosa</i> isolation over the study period warrants continued surveillance. Individualized therapy should be based on age and AMR data.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632047"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphopenia is Associated with Altered Pathogen Distribution and Increased Disease Severity in Viral Pneumonia: A Multicenter Retrospective Cohort Study.","authors":"Yanrui Wu, Xiaoqi Zhang, Lan Yang, Nan Su, Lijuan Li","doi":"10.2147/IDR.S604191","DOIUrl":"10.2147/IDR.S604191","url":null,"abstract":"<p><strong>Background: </strong>Lymphopenia is common in viral pneumonia and has been associated with adverse outcomes. However, its relationship with pathogen distribution, mixed infections, and opportunistic infections across different immune statuses remains incompletely characterized.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study including 2363 adult patients hospitalized with viral pneumonia, of whom 690 were immunocompromised. Patients were stratified into four groups according to immune status and lymphocyte count on admission. Clinical characteristics, laboratory parameters, pathogen profiles, and clinical outcomes were compared across groups. Multivariable logistic regression analyses were performed to identify factors independently associated with in-hospital mortality.</p><p><strong>Results: </strong>Patients with lymphopenia had more severe clinical presentations, higher inflammatory and coagulation markers, and increased severity scores than those without lymphopenia. Across both immune-status strata, patients with lymphopenia had higher observed rates of respiratory failure, invasive mechanical ventilation, ECMO, and in-hospital mortality than those without lymphopenia. Pathogen analyses demonstrated marked differences in pathogen distribution across groups. Immunocompromised patients with lymphopenia showed significantly higher proportions of bacterial co-infections, fungal infections, and mixed infections, particularly involving Aspergillus flavus, Pneumocystis jirovecii, <i>Acinetobacter baumannii</i>, and <i>Pseudomonas aeruginosa</i>. Viral co-infections with human herpesvirus-1 and cytomegalovirus were also more frequent in this group. In multivariable analyses, lymphopenia, advanced age, elevated D-dimer levels, bacterial co-infection, and pre-admission corticosteroid use were independently associated with in-hospital mortality. Overall in-hospital mortality in the cohort was 16.7%, with the highest mortality observed in immunocompromised patients with lymphopenia (27.4%) and the lowest in immunocompetent patients without lymphopenia (7.3%).</p><p><strong>Conclusion: </strong>Lymphopenia is associated with altered pathogen distribution, increased mixed and opportunistic infections, and worse clinical outcomes in viral pneumonia, independent of underlying immune status. Lymphocyte count represents a readily available clinical marker reflecting immune dysfunction and infection complexity, highlighting the need for heightened vigilance and comprehensive pathogen evaluation in patients with viral pneumonia and lymphopenia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"604191"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micturition Syncope Secondary to Urethral Obstruction with Multisystem Complications: A Case Report.","authors":"Min Liu, Yayuan Tan, Jiayi Chen, Meiru Chen, Ziyu Zheng, Jiaxin Hu, Zhaohui Zhang, Haishuang Mei, Dan Jin","doi":"10.2147/IDR.S618473","DOIUrl":"10.2147/IDR.S618473","url":null,"abstract":"<p><p>Critically ill cases of micturition syncope secondary to urethral obstruction with multiple systemic complications are uncommon. A 61-year-old man developed dysuria and sustained high intravesical pressure after ureteroscopic lithotripsy because of postoperative urethral obstruction. Pressure-induced urinary incontinence and syncope subsequently occurred, followed by gross hematuria. The clinical course was complicated by mixed pulmonary infection, severe electrolyte disturbances, rhabdomyolysis, right hydronephrosis, liver injury, and stress-related gastrointestinal bleeding. Micturition syncope was considered the most likely clinical diagnosis based on the complete clinical sequence of dysuria, sustained high intravesical pressure, urinary incontinence, and syncope, together with urinary tract imaging findings and systematic exclusion of cardiogenic, central nervous system, and metabolic causes of altered consciousness. Management included airway-protective mechanical ventilation, staged hemostatic and transfusion support, microbiology-guided antimicrobial therapy, staged fluid replacement and pharmacological correction of internal milieu disturbances, and coordinated multiorgan supportive care. After intensive care treatment, the patient was transferred to a general ward. No recurrence of syncope or hematuria was observed during the 1-month follow-up. This case highlights the importance of early recognition of multiorgan injury and individualized, coordinated management in severe micturition syncope associated with postoperative bladder hypertension and urinary incontinence.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"618473"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymyxin B-Associated Muscle Injury: A Case Report.","authors":"Wenjuan Lei, Jia Xu, Jiao Zhou, Zichao Wei, Min Meng, Chujuan Liu","doi":"10.2147/IDR.S626064","DOIUrl":"10.2147/IDR.S626064","url":null,"abstract":"<p><strong>Background: </strong>Colistin is a last-line antibiotic used to treat multidrug-resistant <i>Acinetobacter baumannii</i>. The most common adverse effects are nephrotoxicity and neurotoxicity. In contrast, there are extremely rare reports of muscle injury induced by polymyxin B, which is related to colistin in its mechanism of action.</p><p><strong>Case presentation: </strong>We report the case of a 63-year-old woman who received polymyxin B (intravenous plus inhalation) combined with tigecycline and vancomycin for pulmonary infection caused by extensive drug resistant <i>Acinetobacter baumannii</i> and bloodstream infection caused by <i>Bacillus cereus</i> following cerebral embolism surgery. During the course of treatment, infection markers gradually improved. However, serum creatine kinase (CK), myoglobin (MB), and serum creatinine (SCr) levels progressively increased. Considering the temporal association between polymyxin B administration and the elevation of serum biomarkers, as well as the causality assessment using the Naranjo scale and WHO-Uppsala Monitoring Centre (WHO-UMC) criteria, polymyxin B-associated muscle injury was suspected. After discontinuation of polymyxin B and initiation of supportive management, laboratory abnormalities gradually resolved, and infection was effectively controlled.</p><p><strong>Conclusion: </strong>Polymyxin B may cause muscle injury presenting with marked MB elevation, a rare but serious adverse reaction. Clinicians should closely monitor CK, MB, and renal function, especially in critically ill patients receiving combination therapy. Early recognition and timely intervention are essential for managing this potential adverse reaction.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"626064"},"PeriodicalIF":3.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amikacin Liposomal Inhalation Suspension: Advances in Application Against Refractory <i>Mycobacterium avium</i> Complex.","authors":"Xin Li, Dan Li, Shuliang Guo, Yuanchun Li","doi":"10.2147/IDR.S627337","DOIUrl":"10.2147/IDR.S627337","url":null,"abstract":"<p><p><i>Mycobacterium avium</i> complex (MAC) is the most prevalent pathogen among slow-growing <i>Nontuberculous mycobacteria</i> (NTM), and the global incidence of MAC pulmonary disease (MAC-PD) continues to rise steadily. Its intrinsic resistance to conventional anti-mycobacterial agents poses a major therapeutic obstacle. Currently, macrolide-based multidrug regimens remain the standard of care; however, treatment options for macrolide-resistant MAC-PD are critically limited, leading to poor outcomes. Refractory MAC-PD is conventionally defined as persistent sputum culture positivity after at least six months of guideline-based macrolide-containing therapy. As a novel targeted preparation, amikacin liposome inhalation suspension (ALIS) utilizes liposomal encapsulation technology to deliver high and sustained intracellular drug concentrations within alveolar macrophages, while significantly reducing systemic toxic and side effects. It is currently the first and only approved inhaled formulation specifically indicated for refractory MAC-PD, and the addition of ALIS to guideline-based therapy significantly improved sputum culture conversion (Phase III CONVERT trial: 29.0% versus 8.9%,). This review systematically dissects the pharmacological rationale, summarizes pivotal clinical trials, including Phase 2/3 clinical trial data and post-marketing real-world evidence, and further discusses the existing limitations and unresolved clinical challenges. Based on the latest research advances, this review aims to provide a comprehensive and practical reference for clinical decision-making in refractory MAC-PD management.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"627337"},"PeriodicalIF":3.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Broad-Spectrum Protective Efficacy of a Fully Human Antibody Cocktail Targeting PcrV, ETA, and PA0833 Against <i>Pseudomonas aeruginosa</i> Infection.","authors":"Xin Xia, Juhao Yang, Deli Shang, Tingting Tang, Yaya Zhao, Hailin Wei, Fusong Wu, Kuan Tang, Xiaoping Bian, Feng Yang","doi":"10.2147/IDR.S630080","DOIUrl":"10.2147/IDR.S630080","url":null,"abstract":"<p><p><i>Pseudomonas aeruginosa (P. aeruginosa)</i> pose a global health threat, with carbapenem-resistant strains in particular posing a grave threat due to high mortality rates and limited treatment options for antibiotic-refractory infections. To address the inherent limitations of single-target therapies, this study developed a multi-target fully human monoclonal antibody (mAb) cocktail targeting three core virulence factors: a key component of the type III secretion system, exotoxin A, and an outer membrane protein. Using a fully human transgenic mouse platform, we generated and characterized three high-affinity mAbs targeting PcrV (U0151, Kd = 2.69 nM), ETA (U0462, Kd = 1.75 nM), and PA0833 (U0057, Kd = 0.34 nM). Functional assays confirmed robust target-specific activities, including neutralization of PcrV-mediated hemolysis, inhibition of ETA-induced cytotoxicity, and enhancement of cell-mediated bacterial clearance. In mouse models of systemic infection and acute pneumonia caused by <i>PAO1</i>, a significant enhancement in efficacy was observed when three types of antibodies were used in combination, increasing protective rates to 78% and 88%, respectively, whereas monotherapies achieved protective rates of no more than 38%. Combined treatment also reduced bacterial burden, alleviated tissue damage, and suppressed excessive neutrophil infiltration. Furthermore, it showed immune protection against several clinical isolates of <i>P. aeruginosa</i>, including carbapenem-resistant strains, within these limits, the data support the three-antibody combination as a candidate adjunctive immunotherapy for multidrug-resistant <i>P. aeruginosa</i> infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"630080"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> Infection with Sulbactam-Durlobactam: A Two-Case Report.","authors":"Fen Liu, Da Wei Wang","doi":"10.2147/IDR.S616892","DOIUrl":"10.2147/IDR.S616892","url":null,"abstract":"<p><strong>Background: </strong>Sulbactam-Durlobactam (SUL-DUR), a novel β-lactam/β-lactamase inhibitor combination, exhibits potent activity against <i>Acinetobacter baumannii</i> isolates, including carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB). Current guidelines recommend SUL-DUR in combination with imipenem-cilastatin or meropenem for the treatment of CRAB pneumonia. However, clinical evidence regarding its use in CRAB bloodstream infections remains limited, and the role of SUL-DUR monotherapy in CRAB pneumonia remains unclear.</p><p><strong>Methods: </strong>We describe two critically ill patients with severe CRAB infections who were successfully treated with SUL-DUR. Clinical characteristics, microbiological findings, antimicrobial regimens, treatment responses, and clinical outcomes were reviewed. The rationale for selecting combination therapy or monotherapy was described according to infection characteristics and individual clinical considerations.</p><p><strong>Results: </strong>The first patient developed CRAB bloodstream infection following severe trauma and was successfully treated with SUL-DUR combined with imipenem-cilastatin, achieving rapid clearance of blood cultures and clinical improvement. The second patient developed CRAB pneumonia in the context of pulmonary <i>Aspergillus fumigatus</i> infection requiring antifungal therapy. Considering the absence of concurrent bacterial pathogens and concerns regarding additional broad-spectrum antimicrobial exposure, SUL-DUR monotherapy was selected as an individualized treatment strategy and resulted in resolution of fever, improvement of pulmonary lesions, and successful ventilator liberation.</p><p><strong>Conclusion: </strong>These two cases expand the clinical experience of SUL-DUR in severe CRAB infections, demonstrating successful treatment of CRAB bloodstream infection with SUL-DUR-based combination therapy and favorable outcomes of individualized SUL-DUR monotherapy for selected monomicrobial CRAB pneumonia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"616892"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}