Objective To evaluate the efficacy of sulbactam-durlobactam based anti-infective therapy in patients co-infected with carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods A retrospective analysis was conducted on medical records of patients co-infected with CRAB and CRKP who received sulbactam-durlobactam treatment at West China Hospital, Sichuan University, between January 2025 and January 2026. Data collected included demographic characteristics, underlying diseases, microbiological findings, antimicrobial regimens, and clinical outcomes. Results A total of eight patients were included, with treatment failure in four. Patients who experienced treatment failure predominantly had severe underlying diseases and were immunocompromised. All CRAB isolates tested for resistance genes harbored blaOXA-23, while CRKP isolates predominantly carried blaKPC, with three isolates co-producing multiple carbapenemases. The primary treatment regimen was sulbactam-durlobactam combined with ceftazidime-avibactam. Notably, one patients developed CRKP infection during sulbactam-durlobactam therapy for CRAB infection. Conclusions The management of patients co-infected with CRAB and CRKP remains challenging and is associated with poor prognosis. A comprehensive, multimodal approach is urgently needed to reduce mortality in this population.
