Multidrug-resistant bacteria in hematology patients: Emerging threats

Paola Tatarelli, Malgorzata Mikulska

Research output: Contribution to journalArticlepeer-review

Abstract

Multidrug-resistant (MDR) bacteria, particularly Gram negatives, such as Enterobacteriaceae resistant to third-generation cephalosporins or carbapenems and MDR Pseudomonas aeruginosa, are increasingly frequent in hematology patients. The prevalence of different resistant species varies significantly between centers. Thus, the knowledge of local epidemiology is mandatory for deciding the most appr-opriate management protocols. In the era of increasing antibiotic resistance, empirical therapy of febrile neutropenia should be individualized. A de-escalation approach is recommended in case of severe clinical presentation in patients who are at high risk for infection with a resistant strain. Targeted therapy of an MDR Gram negative usually calls for a combination treatment, although no large randomized trials exist in this setting. Infection control measures are the cornerstone of limiting the spread of MDR pathogens in hematology units.

Original languageEnglish
Pages (from-to)767-780
Number of pages14
JournalFuture Microbiology
Volume11
Issue number6
DOIs
Publication statusPublished - Jun 1 2016

Keywords

  • antimicrobial stewardship
  • combination treatment
  • de-escalation
  • febrile neutropenia
  • infection control
  • multidrug-resistant bacteria
  • selective digestive decontamination
  • β-lactamase inhibitors

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

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