{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:50:07Z","timestamp":1787759407371,"version":"build-2784847793"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acinetobacter baumannii is a nosocomial pathogen known for rapidly developing resistance to nearly all antibiotics, including last-line agents. Cefiderocol, a novel siderophore cephalosporin, has shown in vitro activity against A. baumannii and is now used clinically, but resistance is emerging. Data on cefiderocol-based antibiotic combinations are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the in vitro activity of cefiderocol alone and in combination with other antibiotics against XDR and PDR A. baumannii clinical isolates, and to explore resistance mechanisms underlying cefiderocol synergy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We tested 21 XDR\/PDR clinical isolates and one NDM-1-producing strain using broth microdilution and checkerboard assays with cefiderocol and 17 antibiotics, including ceftazidime\/avibactam, sulbactam\/durlobactam, and amikacin. Synergy was determined through checkerboard assays and calculating fractional inhibitory concentration indices (FICI). WGS was used to identify resistance genes in selected strains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cefiderocol alone was active against 66.7% of strains and demonstrated synergy with ceftazidime\/avibactam and sulbactam\/durlobactam in 100% and 95.2% of strains, respectively, and with amikacin, doxycycline and sulbactam in over half of strains. Cefiderocol-based combinations also reduced cefiderocol MICs against an NDM-1-producing strain. WGS revealed \u03b2-lactamases and resistance determinants among both susceptible and resistant isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Several cefiderocol-containing combinations show strong in vitro synergy against XDR and PDR A. baumannii. These combinations, especially cefiderocol-ceftazidime\/avibactam and cefiderocol\u2013sulbactam\/durlobactam, may enhance treatment of highly resistant A. baumannii strains and warrant further clinical investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf306","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T11:53:27Z","timestamp":1754567607000},"page":"2814-2824","source":"Crossref","is-referenced-by-count":10,"title":["Synergistic cefiderocol-containing antibiotic combinations active against highly drug-resistant\n                    <i>Acinetobacter baumannii<\/i>\n                    patient isolates with diverse resistance mechanisms"],"prefix":"10.1093","volume":"80","author":[{"given":"Justin","family":"Halim","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Cooper Medical School of Rowan University , Camden, NJ 08103 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