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

Maillard, Alexis; Dortet, Laurent; Delory, Tristan; Lafaurie, Matthieu; Bleibtreu, Alexandre; Treatment of AmpC producing Enterobacterales study group · Clin Infect Dis · 2024

retrospective_cohort · Level III

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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%).

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