Antibiotic definitive treatment in ventilator associated pneumonia caused by AmpC-producing Enterobacterales in critically ill patients: a prospective multicenter observational study

  • Published on 12/02/2024
  •  Reading time: 5 min.

Petit Matthieu 1, Bidar Frank 2, Fosse Quentin 3, Lefevre Lucie 4, Paul Marine 5, Urbina Tomas 6, Masi Paul 7, Bavozet Florent 8, Lemarié Jérémie 9, de Montmollin Etienne 10, Andriamifidy-Berti Chloé 11, Dessajan Julien 12, Zuber Benjamin 13, Zafrani Lara 14, Peju Edwige 15, Meng Paris 16, Charrier Liliane 17, Le Guennec Loic 18, Simon Marie 19, Luyt Charles-Edouard 20, Haudebourg Luc 21, Geri Guillaume 22

1 https://ror.org/03j6rvb05 Medical Intensive Care Unit, Ambroise Paré Hospital, APHP, UMR 1018 CESP Villejuif 9, Avenue Charles de Gaulle Boulogne-Billancourt France
2 Anesthesia and Critical Care Medicine Department Hospices Civils de Lyon, Edouard Herriot Hospital Lyon France
3 https://ror.org/03xjwb503 AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS Université Paris-Saclay Le Kremlin-Bicêtre France
4 Médecine Intensive Réanimation, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris Sorbonne-Université, Hôpital Pitié-Salpêtrière Paris France
5 Intensive Care Unit Centre Hospitalier de Versailles-Site André Mignot Le Chesnay France
6 Service de Médecine Intensive Réanimation Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris Paris France
7 https://ror.org/033yb0967 AP-HP Hôpitaux Universitaires Henri-Mondor Service de Médecine Intensive Réanimation 94010 Créteil France
8 CH de Dreux Médecine Intensive Réanimation Dreux France
9 https://ror.org/05c1qsg97 Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes Centre Hospitalier Universitaire Hôtel-Dieu Nantes France
10 https://ror.org/05f82e368 INSERM UMR 1137, 75018, Department of Intensive Care Medicine, APHP, Bichat-Claude Bernard University Hospital Université Paris Cité 75018 Paris France
11 Médecine Intensive - Réanimation Centre Hospitalier de Poissy - Saint Germain en Laye Poissy France
12 Service de Médecine Intensive-Réanimation Hôpital Tenon, Assistance Publique-Hôpitaux de Paris Paris France
13 https://ror.org/058td2q88 Intensive Care Unit Hôpital Foch 92150 Suresnes France
14 Medical Intensive Care Unit, Saint-Louis Hospital, AP-HP University of Paris Cité Paris France
15 Medical Intensive Care Unit, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris AP-HP Centre Université Paris Cité Paris France
16 Service de Médecine Intensive Réanimation CHI Robert Ballanger Aulnay-sous-Bois France
17 https://ror.org/04fev8a92 Service de Réanimation Centre Hospitalier du Cotentin Cherbourg France
18 Médecine Intensive Réanimation Neurologique, Hôpital de la Pitié-Salpêtrière - APHP Sorbonne Université Paris France
19 Médecine Intensive Et Réanimation CHU Edouard Herriot Lyon France
20 Service de Médecine Intensive Réanimation, Institut de Cardiologie, ICAN, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris Sorbonne-Université, Hôpital Pitié-Salpêtrière Paris France
21 Service de Pneumologie et Réanimation Médicale du Département R3S Groupe Hospitalier Pitié-Salpêtrière Charles Foix, AP-HP Paris France
22 https://ror.org/047wq3n50 Medical and Surgical Intensive Care Unit Ambroise Paré Clinic Neuilly-sur-Seine France

Abstract

Background Ventilator associated pneumonia (VAP) due to wild-type AmpC-producing Enterobacterales (wtAE) is frequent in intensive care unit (ICU) patients. Despite a low level of evidence, definitive antimicrobial therapy (AMT) with third generation cephalosporins (3GCs) or piperacillin is discouraged.
Methods Observational prospective study including consecutive wtAE VAP patients in 20 French ICUs. The primary objective was to assess the association of...

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