Global impact of antibacterial resistance in patients with hematologic malignancies and hematopoietic cell transplant recipients

Abstract

Patients with hematologic malignancies and hematopoietic cell transplant (HCT) recipients are at high risk of developing bacterial infections. These patients may suffer severe consequences from these infections if they do not receive immediate effective therapies, and thus are uniquely threatened by antimicrobial‐resistant bacteria. Here, we outline how the emergence of specific resistant bacteria threatens the effectiveness of established approaches to prevent and treat infections in this population. The emergence of fluoroquinolone resistance among Enterobacterales and viridans group streptococci may decrease the effectiveness of fluoroquinolone prophylaxis during neutropenia. The emergence of Enterobacterales that produce extended‐spectrum β‐lactamases or carbapenemases and of increasingly resistant Pseudomonas aeruginosa may result in neutropenic patients experiencing delayed time to active antibacterial therapy, and consequently worse clinical outcomes. The ability to select targeted antibacterial therapies after the availability of susceptibility data may be limited in patients infected with metallo‐β‐lactamase‐producing Enterobacterales and difficult‐to‐treat P. aeruginosa. Vancomycin‐resistant enterococci and Stenotrophomonas maltophilia can cause breakthrough infections in patients already being treated with broad‐spectrum β‐lactam antibiotics. Resistance can also limit the ability to provide oral stepdown antibacterial therapy for patients who could otherwise be discharged from hospitalization. We also outline strategies that have the potential to mitigate the negative impact of antimicrobial resistance, including interventions based on active screening for colonization with resistant bacteria and the use of novel rapid diagnostic assays. Additional research is needed to better understand how these strategies can be leveraged to combat the emerging crisis of antimicrobial resistance in patients with hematologic malignancies and HCT recipients.

Alginate Cryogels for Rapid Hemostasis and Toluidine Blue-Mediated Photodynamic Inactivation of Bacteria

“…15,16 However, this approach has drawbacks, including the risk of antibiotic resistance. 17,18 Eventually, it is predicted by World Health Organization that about 10 million people will die of antimicrobial resistance each by 2050. 19 To tackle this issue, nonantibiotic antibacterial methods like photothermal therapy (PTT), sonodynamic therapy, chemodynamic therapy, and photodynamic therapy (PDT) have gained attention.…”

“…To address bacterial infections in wounds using cryogels, researchers have traditionally added antibiotics to create antibacterial cryogels. , However, this approach has drawbacks, including the risk of antibiotic resistance. , Eventually, it is predicted by World Health Organization that about 10 million people will die of antimicrobial resistance each by 2050 . To tackle this issue, nonantibiotic antibacterial methods like photothermal therapy (PTT), sonodynamic therapy, chemodynamic therapy, and photodynamic therapy (PDT) have gained attention. − PDT, in particular, is promising because it generates singlet oxygen ( 1 O 2 ) upon laser exposure, effectively killing bacteria without causing resistance. , Cryogel materials have porous structure.…”