Genotype-Phenotype Concordance and Ct-Informed Predictive Rules for Antimicrobial Resistance in Adult Patients with Complicated Urinary Tract Infections: Clinical and Stewardship Implications from the NCT06996301 Trial.

ABSTRACT: Background: Rapid molecular detection of antimicrobial resistance (AMR) can shorten time to effective therapy in complicated urinary tract infections (cUTI), but the ability of gene presence and quantitative PCR signal (Ct, and ΔCt = Ct_marker - IC_Ct) to predict phenotypic non-susceptibility and clinical outcomes requires rigorous evaluation. We analyzed marker-level concordance, Ct→MIC relationships, and the clinical impact pathway in the randomized NCT06996301 trial. Methods: Marker-phenotype concordance metrics (sensitivity, specificity, PPV, NPV, LR+, LR-, κ) were computed for selected marker × species strata with stable sample sizes. Mixed-effects models (log₂[MIC] ~ ΔCt_marker + IC_Ct + collection_method + prior_abx + (1|site)) assessed quantitative Ct→MIC a

SUBMITTER: Kardjadj M 

PROVIDER: S-EPMC12691348 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature