Mutation Rate of AmpC β-Lactamase–Producing Enterobacterales and Treatment in Clinical Practice: A Word of Caution

Abstract In a retrospective multicenter study of 575 patients with bloodstream infections or pneumonia due to wild-type AmpC β-lactamase–producing Enterobacterales, species with low in vitro mutation rates for AmpC derepression were associated with fewer treatment failures due to AmpC overproduction...

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Veröffentlicht in:	Clinical infectious diseases 2024-07, Vol.79 (1), p.52-55
Hauptverfasser:	Maillard, Alexis, Dortet, Laurent, Delory, Tristan, Lafaurie, Matthieu, Bleibtreu, Alexandre
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Bacteremia - drug therapy Bacteremia - microbiology Bacterial Proteins - genetics beta-Lactamases - genetics beta-Lactamases - metabolism Cephalosporins - pharmacology Cephalosporins - therapeutic use Enterobacteriaceae - drug effects Enterobacteriaceae - enzymology Enterobacteriaceae - genetics Enterobacteriaceae Infections - drug therapy Enterobacteriaceae Infections - microbiology Female Humans Male Microbial Sensitivity Tests Middle Aged Mutation Rate Retrospective Studies
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Zusammenfassung:	Abstract In a retrospective multicenter study of 575 patients with bloodstream infections or pneumonia due to wild-type AmpC β-lactamase–producing Enterobacterales, species with low in vitro mutation rates for AmpC derepression were associated with fewer treatment failures due to AmpC overproduction (adjusted hazard ratio, 0.5 [95% CI, .2–.9]). However, compared to cefepime/carbapenems, using third-generation cephalosporins as definitive therapy remained associated with this adverse outcome (15% vs 1%). Graphical abstract Graphical abstract
ISSN:	1058-4838 1537-6591 1537-6591
DOI:	10.1093/cid/ciae160