Infection and Drug Resistance (Sep 2021)

Sulbactam Enhances in vitro Activity of β-Lactam Antibiotics Against Acinetobacter baumannii

  • Wang L,
  • Chen Y,
  • Han R,
  • Huang Z,
  • Zhang X,
  • Hu F,
  • Yang F

Journal volume & issue
Vol. Volume 14
pp. 3971 – 3977

Abstract

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Leilei Wang,1,2 Yuancheng Chen,1– 3 Renru Han,1,2 Zhiwei Huang,1– 3 Xuefei Zhang,1,2 Fupin Hu,1,2 Fan Yang1,2 1Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, People’s Republic of China; 3Phase I Clinical Research Center, Huashan Hospital, Fudan University, Shanghai, People’s Republic of ChinaCorrespondence: Fan Yang; Fupin HuInstitute of Antibiotics, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Shanghai, 200040, People’s Republic of ChinaTel +86 21 52888193Email [email protected]; [email protected]: To evaluate in vitro activities of β-lactam antibiotics alone and in combination with sulbactam at different ratios against Acinetobacter baumannii clinical strains from China.Methods: A total of 300 clinical isolates of A. baumannii were collected from 29 hospitals across China in 2018. Susceptibility to common antibiotics was assessed, and β-lactamase genes were detected. In vitro activity of ampicillin, cefoperazone and imipenem was tested alone and in combination with sulbactam at the ratios of 2:1, 1:1, 1:1.5, 1:2, 1:2.5 and 1:3.Results: High resistant rates for common antibiotics were observed except tigecycline and polymyxin B. Among carbapenem-resistant A. baumannii, 97.3% isolates harbored blaOXA-23. MIC50 and MIC90 values for sulbactam were 32 mg/L and 64 mg/L, respectively. High resistant rates for ampicillin, cefoperazone and imipenem were observed (92.3%, 93% and 85.3%, respectively). A stepwise increase in the ratio of sulbactam to partner β-lactam antibiotics led to a stepwise decrease in the MICs and a stepwise increase in the susceptible rates. The susceptible rates for imipenem-sulbactam 1:3, ampicillin-sulbactam 1:3 and cefoperazone-sulbactam 1:3 reached 16.3%, 58.3% and 91%, respectively.Conclusion: The increasing proportion of sulbactam could enhance antimicrobial activities of imipenem-sulbactam, ampicillin-sulbactam and cefoperazone-sulbactam combinations against A. baumannii clinical strains in China, with cefoperazone-sulbactam as the most potent compound.Keywords: sulbactam, ampicillin, cefoperazone, imipenem, Acinetobacter baumannii

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