{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:08:28Z","timestamp":1791331708320,"version":"4.3.1"},"reference-count":52,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Introduction: Due to the limited therapeutic options for patients with Acinetobacter baumannii complex infections, a new combination antimicrobial agent, sulbactam\u2013durlobactam, has been developed. In this systematic review, we evaluated the available data on the resistance of A. baumannii complex clinical isolates to sulbactam\u2013durlobactam. Methods: We performed a thorough search of four databases for relevant studies. The Clinical and Laboratory Standards Institute (CLSI) sulbactam\u2013durlobactam breakpoint for A. baumannii complex susceptibility was used (MIC value \u22644 mg\/L). Data on the presence of genes of various \u03b2-lactamases were also analyzed. Results: From 182 identified articles, 84 were thoroughly screened. Data extraction was performed on 20 articles (published 2017\u20132025) reporting on a total of 10,412 A. baumannii complex clinical isolates. Among the various \u03b2-lactamases genes present, the OXA subvariants OXA-23\/OXA-23-like were the most common (in 561 isolates). The proportions of non-selected (consecutive) A. baumannii isolates found to be resistant to sulbactam\u2013durlobactam were 1.2%, 1.2%, and 4.6% in the three studies, and with non-susceptibility (resistance and intermediate resistance) were 2%, 2.1%, and 4.6% in three other studies. Non-susceptibility was very rare among A. calcoaceticus, A. nosocomialis, and A. pittii isolates (0%, 0.3%, and 0.6%, respectively). The proportion of carbapenem-resistant A. baumannii isolates with resistance was 0\u20135.2%. The proportion of A. baumannii isolates selected for their reduced susceptibility profile (including reduced susceptibility to cefiderocol) with resistance was 1.4\u201327.3%. Discussion: The low proportion of sulbactam\u2013durlobactam resistance among A. baumannii complex isolates supports the consideration of the use of this new antibiotic for its approved indications.<\/jats:p>","DOI":"10.3390\/pathogens14101062","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T15:20:12Z","timestamp":1760973612000},"page":"1062","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Resistance of Acinetobacter baumannii Complex Clinical Isolates to Sulbactam\u2013Durlobactam: A Systematic Review of Data from In Vitro Studies"],"prefix":"10.3390","volume":"14","author":[{"given":"Matthew E.","family":"Falagas","sequence":"first","affiliation":[{"name":"Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Greece"},{"name":"School of Medicine, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus"},{"name":"Department of Medicine, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura T.","family":"Romanos","sequence":"additional","affiliation":[{"name":"Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Ragias","sequence":"additional","affiliation":[{"name":"Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9324-1641","authenticated-orcid":false,"given":"Charalampos","family":"Filippou","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"R48","DOI":"10.1186\/cc4869","article-title":"Attributable Mortality of Acinetobacter Baumannii Infections in Critically Ill Patients: A Systematic Review of Matched Cohort and Case-Control Studies","volume":"10","author":"Falagas","year":"2006","journal-title":"Crit. 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