Successful Use of Sulbactam-Durlobactam in Treating Carbapenem-Resistant Acinetobacter baumannii Pneumonia and Sepsis After Liver Transplantation: A Case Report
Abstract
Patient: Female, 22-year-old Final Diagnosis: Acute liver failure • postoperative infections with carbapenem-resistant Acinetobacter baumannii and multidrug-resistant Klebsiella pneumoniae Symptoms: Fatigue • poor appetite • nausea and altered consciousness Clinical Procedure: — Specialty: Critical Care Medicine • Gastroenterology and Hepatology Objective: Unusual clinical course Background Orthotopic liver transplantation is the primary treatment for end-stage liver disease; however, postoperative infections, especially those caused by carbapenem-resistant Acinetobacter baumannii (CRAB), remain a major cause of mortality due to limited therapeutic options. Sulbactam–durlobactam (SUL-DUR), a novel β-lactam/β-lactamase inhibitor combination, has shown potent activity against CRAB. This report describes the first reported use of SUL-DUR in a liver transplant recipient with CRAB pneumonia and sepsis. Case Report A 22-year-old woman with acute liver failure underwent auxiliary liver transplantation. Postoperatively, she developed CRAB pneumonia and septicemia confirmed by imaging, bronchoscopy, and metagenomic next-generation sequencing. She received combination therapy with SUL-DUR (1 g/1 g every 8 h), meropenem, eravacycline, and neutralized polymyxin B. Blood and sputum cultures confirmed CRAB susceptibility to SUL-DUR. Following treatment, inflammatory markers (CRP, IL-6, PCT) and pathogen loads markedly decreased, leading to complete clinical resolution without significant…
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