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Carbapenem-Resistant Enterobacteriaceae—Implications for Treating Acute Leukemias, a Subgroup of Hematological Malignancies

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Department of Medicine, Stord Hospital, 5416 Stord, Norway
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Department of Microbiology, Haukeland University Hospital, 5021 Bergen, Norway
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Department of Clinical Science, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway
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Department of Medicine, Førde Hospital, 6812 Førde, Norway
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Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
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Faculty of Health, VID Specialized University, 5020 Bergen, Norway
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Department of Cardiology, Haukeland University Hospital, 5021 Bergen, Norway
*
Author to whom correspondence should be addressed.
Academic Editor: Marc Maresca
Antibiotics 2021, 10(3), 322; https://doi.org/10.3390/antibiotics10030322
Received: 12 February 2021 / Revised: 15 March 2021 / Accepted: 16 March 2021 / Published: 19 March 2021
Acute leukemias (AL) are a group of aggressive malignant diseases associated with a high degree of morbidity and mortality. Patients with AL are highly susceptible to infectious diseases due to the disease itself, factors attributed to treatment, and specific individual risk factors. Enterobacteriaceae presence (e.g., Klebsiella pneumonia and Escherichia coli) is a frequent cause of bloodstream infections in AL patients. Carbapenem-resistant Enterobacteriaceae (CRE) is an emerging health problem worldwide; however, the incidence of CRE varies greatly between different regions. Carbapenem resistance in Enterobacteriaceae is caused by different mechanisms, and CRE may display various resistance profiles. Bacterial co-expression of genes conferring resistance to both broad-spectrum β-lactam antibiotics (including carbapenems) and other classes of antibiotics may give rise to multidrug-resistant organisms (MDROs). The spread of CRE represents a major treatment challenge for clinicians due to lack of randomized clinical trials (RCTs), a limited number of antibiotics available, and the side-effects associated with them. Most research concerning CRE infections in AL patients are limited to case reports and retrospective reviews. Current research recommends treatment with older antibiotics, such as polymyxins, fosfomycin, older aminoglycosides, and in some cases carbapenems. To prevent the spread of resistant microbes, it is of pivotal interest to implement antibiotic stewardship to reduce broad-spectrum antibiotic treatment, but without giving too narrow a treatment to neutropenic infected patients. View Full-Text
Keywords: carbapenem-resistant Enterobacteriaceae; infections; acute leukemia carbapenem-resistant Enterobacteriaceae; infections; acute leukemia
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MDPI and ACS Style

Storhaug, K.Ø.; Skutlaberg, D.H.; Hansen, B.A.; Reikvam, H.; Wendelbo, Ø. Carbapenem-Resistant Enterobacteriaceae—Implications for Treating Acute Leukemias, a Subgroup of Hematological Malignancies. Antibiotics 2021, 10, 322. https://doi.org/10.3390/antibiotics10030322

AMA Style

Storhaug KØ, Skutlaberg DH, Hansen BA, Reikvam H, Wendelbo Ø. Carbapenem-Resistant Enterobacteriaceae—Implications for Treating Acute Leukemias, a Subgroup of Hematological Malignancies. Antibiotics. 2021; 10(3):322. https://doi.org/10.3390/antibiotics10030322

Chicago/Turabian Style

Storhaug, Kristin Ø., Dag H. Skutlaberg, Bent A. Hansen, Håkon Reikvam, and Øystein Wendelbo. 2021. "Carbapenem-Resistant Enterobacteriaceae—Implications for Treating Acute Leukemias, a Subgroup of Hematological Malignancies" Antibiotics 10, no. 3: 322. https://doi.org/10.3390/antibiotics10030322

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