A Primer on AmpC β-Lactamases: Necessary Knowledge for an Increasingly Multidrug-resistant World
Year: 2019
Type: review
Abstract: Understanding the nuances of AmpC β-lactamase-mediated resistance can be challenging, even for the infectious diseases specialist. AmpC resistance can be classified into 3 categories: (1) inducible chromosomal resistance that emerges in the setting of a β-lactam compound, (2) stable derepression due to mutations in ampC regulatory genes, or (3) the presence of plasmid-mediated ampC genes. This review will mainly focus on inducible AmpC resistance in Enterobacteriaceae. Although several observational studies have explored optimal treatment for AmpC producers, few provide reliable insights into effective management approaches. Heterogeneity within the data and inherent selection bias make inferences on effective β-lactam choices problematic. Most experts agree it is prudent to avoid expanded-spectrum (ie, third-generation) cephalosporins for the treatment of organisms posing the greatest risk of ampC induction, which has best been described in the context of Enterobacter cloacae infections. The role of other broad-spectrum β-lactams and the likelihood of ampC induction by other Enterobacteriaceae are less clear. We will review the mechanisms of resistance and triggers resulting in AmpC expression, the species-specific epidemiology of AmpC production, approaches to the detection of AmpC production, and treatment options for AmpC-producing infections.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciz173
Authors: Pranita D Tamma, Yohei Doi, Robert A Bonomo, J Kristie Johnson, Patricia J Simner, Antibacterial Resistance Leadership Group, P D Tamma, Y Doi, R A Bonomo
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Challenges in beta-Lactamase Mediated Resistance, Real-Time Whole Genome Sequencing Analysis of Carbapenemase-Producing Organisms in the Non-Outbreak Hospital Setting, Study Network of Acinetobacter as a Carbapenem-Resistant Pathogen (SNAP), Colistin resistance in extensively drug-resistant Gram-negative pathogens, A Mechanism Based Approach to Metallo beta-lactamase Inhibition, Understanding B-Lactam Resistance in Acinetobacter baumannii, Antibacterial Resistance Leadership Group (ARLG), Mechanisms and implications of fosfomycin resistance in Escherichia coli, The Use of MALDI TOF for the Rapid Detection of Carbapenemases from Clinical Isolates
OpenAlex ID: W2921330592