Yu Feng, Laurent Poirel, Zhiyong Zong
Sulbactam-durlobactam is the first-line agent against carbapenem-resistant Acinetobacter baumannii. Resistance can be conferred by metallo-β-lactamases alone or penicillin-binding protein 3 alterations plus β-lactamase overproduction or enhanced efflux. Other reported mechanisms remain associative and resistance in guideline-recommended carbapenem addition is unclear, underscoring the need for mechanistic validation and further studies.