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P40 Evaluation of sulbactam/durlobactam activity against carbapenem-resistant Acinetobacter baumannii in India: an institutional experience

Title: P40 Evaluation of sulbactam/durlobactam activity against carbapenem-resistant Acinetobacter baumannii in India: an institutional experience
Authors: Nizam Ahmed, M; Singh, Parul; Kirti, Madhavi; Das, Bharat Chandra; Tluanpuii, Vanlal; Kumar, Subodh; Sagar, Sushma; Soni, Kapil Dev; Aggarwal, Richa; Bindra, Ashish; Goyal, Keshav; Singh, Gyanendra Pal; Sokhal, Navdeep; Farooque, Kamran; Mathur, Purva
Source: JAC-Antimicrobial Resistance ; volume 7, issue Supplement_4 ; ISSN 2632-1823
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Background Carbapenem-resistant Acinetobacter baumannii (CRAB) is a WHO designated ‘critical priority’ pathogen because of its high capacity for multidrug resistance and association with mortality rates approaching 50% in severe hospital-acquired infections. CRAB is a major driver of ventilator-associated pneumonia (VAP), bloodstream infections and wound infections in critically ill patients, especially in intensive care units. Treatment options are severely limited, with colistin and minocycline often used as last-resort agents despite toxicity concerns. The recently concluded ATTACK trial demonstrated that sulbactam/durlobactam, a novel β-lactam/β-lactamase inhibitor combination, was superior to colistin in terms of efficacy and safety, establishing it as a preferred therapeutic option in global guidelines. Surveillance programmes have consistently reported very high activity, with more than 96% of CRAB isolates worldwide remaining susceptible. However, antimicrobial resistance (AMR) in India is distinct, with carbapenem resistance driven not only by OXA-type carbapenemases but also by endemic metallo-β-lactamases (MBLs) and frequent treatment exposures to broad-spectrum agents. Therefore, regional evaluation of sulbactam/durlobactam is crucial before incorporation into local treatment algorithms. Methods A prospective laboratory-based surveillance was conducted over four months at a tertiary-care teaching hospital. A total of 175 non-duplicate CRAB clinical isolates were collected. The majority originated from respiratory samples (n=140; 80%), reflecting the heavy burden of ventilator-associated and hospital-acquired pneumonia. Additional sources included blood (n=18; 10%), pus/wound swabs (n=7; 4%) and other sterile body fluids (n=10; 6%). All isolates were confirmed as A. baumannii by VITEK MS® (bioMérieux®, France). Antimicrobial susceptibility testing was performed by disc diffusion, and sulbactam/durlobactam activity was assessed using CLSI-M100 2024. A. baumannii SAMN04901667(AR Bank) was ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/jacamr/dlaf230.047
Availability: https://doi.org/10.1093/jacamr/dlaf230.047; https://academic.oup.com/jacamr/article-pdf/7/Supplement_4/dlaf230.047/65727837/dlaf230.047.pdf
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.8BA9BDF3
Database: BASE