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Multicenter Study
. 2024 Jul 19;79(1):52-55.
doi: 10.1093/cid/ciae160.

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

Alexis Maillard  1 , Laurent Dortet  2   3   4 , Tristan Delory  5 , Matthieu Lafaurie  6 , Alexandre Bleibtreu  1   7 ; Treatment of AmpC producing Enterobacterales study group
Collaborators, Affiliations
Multicenter Study

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

Alexis Maillard et al. Clin Infect Dis. .

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%).

Keywords: AmpC β-lactamase; Enterobacterales; antibiomicrobial therapy; bloodstream infection; pneumonia.

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Conflict of interest statement

Potential conflicts of interest. A. B. declares links of interest with Pfizer, Shionogi, Eumedica, Sanofi, Gilead, Astellas, Menarini, and Janssen for congress fees, symposia, or investigator in clinical studies. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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