The prevention and management of infections due to multidrug resistant organisms in haematology patients

Br J Clin Pharmacol. 2015 Feb;79(2):195-207. doi: 10.1111/bcp.12310.

Abstract

Infections due to resistant and multidrug resistant (MDR) organisms in haematology patients and haematopoietic stem cell transplant recipients are an increasingly complex problem of global concern. We outline the burden of illness and epidemiology of resistant organisms such as gram-negative pathogens, vancomycin-resistant Enterococcus faecium (VRE), and Clostridium difficile in haematology cohorts. Intervention strategies aimed at reducing the impact of these organisms are reviewed: infection prevention programmes, screening and fluoroquinolone prophylaxis. The role of newer therapies (e.g. linezolid, daptomycin and tigecycline) for treatment of resistant and MDR organisms in haematology populations is evaluated, in addition to the mobilization of older agents (e.g. colistin, pristinamycin and fosfomycin) and the potential benefit of combination regimens.

Keywords: fluoroquinolone prophylaxis; haematology; healthcare-associated infection; multiresistant gram negatives; vancomycin-resistant enterococci (VRE).

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacology*
  • Antibiotic Prophylaxis / methods
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Bacterial Infections / prevention & control
  • Cost of Illness
  • Drug Resistance, Multiple, Bacterial
  • Global Health
  • Hematologic Diseases / complications*
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans

Substances

  • Anti-Bacterial Agents