探讨舒巴坦-度洛巴坦联合美罗培南治疗泛耐药鲍曼不动杆菌（XDR-AB）致重症医院获得性肺炎的有效性。

回顾性分析2025年5月1日首都医科大学附属北京安贞医院呼吸与危重症医学科收治的1例医院获得性XDR-AB重症肺炎患者的病历资料并进行相关文献复习。

76岁男性，因“反复发热，伴咳嗽、咯痰2 d”收入本院。入院胸部CT显示双下肺弥漫性磨玻璃渗出影，灌洗液宏基因组测序（mNGS）提示人类疱疹病毒1型（102条）感染，结合临床表现及实验室检查，给予更昔洛韦抗病毒及美罗培南联合万古霉素抗细菌治疗。在治疗过程中发生医院获得性XDR-AB重症肺炎及脓毒性休克，药敏试验提示对替加环素、复方新诺明、依拉环素和舒巴坦-度洛巴坦敏感，体温最高42 ℃，炎性指标（白细胞计数、C-反应蛋白和降钙素原水平等）明显升高，使用舒巴坦-度洛巴坦（1.0 g/1.0 g/次、静脉滴注，1次/6 h）联合美罗培南（1.0 g/次、静脉滴注，1次/8 h）治疗5 d后感染症状明显改善，顺利出院，避免了Ⅱ型呼吸衰竭导致的气管插管。国内外有病例报道使用舒巴坦-度洛巴坦联合亚胺培南治疗XDR-AB感染，本病例结合患者既往史调整治疗方案，显示联合美罗培南也可实现临床治愈和微生物清除。

舒巴坦-度洛巴坦联合美罗培南治疗XDR-AB所致医院获得性肺炎，对改善患者症状和清除病原体有积极作用。

To investigate the efficacy of Sulbactam-Durlobactam combined with Meropenem in treatment of extensively drug-resistant Acinetobacter baumannii (XDR-AB)-associated severe hospital-acquired pneumonia.

Retrospective analysis of a case with severe pneumonia caused by XDR-AB who was admitted to Beijing Anzhen Hospital, Capital Medical University on May 1st, 2025 and relevant literatures were reviewed.

A 76-year-old male was hospitalized due to “recurrent fever accompanied by cough and sputum for 2 days”. Chest CT revealed diffused ground-glass opacities in bilateral lower lobes. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid identified human herpesvirus type 1 (102 reads) infection. Based on the clinical manifestations and laboratory tests, ganciclovir was administered for antiviral treatment, and meropenem combined with vancomycin were used for antibacterial treatment. Hospital-acquired severe pneumonia caused by XDR-AB infection and septic shock occurred during the treatment. XDR-AB was sensitive to Tigecycline, Cotrimoxazole, Eravacycline and Sulbactam-Durlobactam, and the highest body temperature of the patient reached 42 ℃, and levels of inflammatory indicators (count of white blood cells, levels of C-reactive protein and procalcitonin, etc.) increased significantly. After 5 days treatment with Sulbactam-Durlobactam (1.0 g/1.0 g per dose via intravenous drip, every 6 hours) and Meropenem (1.0 g per dose via intravenous drip, every 8 hours), the patient’s infection status improved significantly, and was discharged avoiding endotracheal intubation caused by type Ⅱ respiratory failure. Domestic and international studies had reported successful treatment of XDR-AB infections using Sulbactam-Durlobactam in combination with Imipenem. This case demonstrated that adjusting the treatment regimen based on the patient’s medical history, with the addition of Meropenem, could achieve both clinical cure and microbial eradication.

The combination of Sulbactam-Durlobactam and Meropenem could effectively treat hospital-acquired pneumonia caused by XDR-AB, and can significantly improve the patient’s symptoms and eliminate the pathogens.