Challenges in Infectious Diseases for Haematologists

Abstract

Infections remain a threat for patients with haematological malignancies. In accordance with the European Hematology Association roadmap we provide a concise overview regarding the most relevant current challenges in infectious diseases for haematologists. These include bacterial infections and the need for antibiotic stewardship as well as infections with community-acquired respiratory viruses, infections in patients receiving targeted therapies, re-activations of latent infections and vaccination strategies. The following review intends to summarise the most relevant information for clinicians currently caring for patients with haematological malignancies. Recommendations given are based on the guidelines published by the Infectious Diseases Working Party of the German Society of Haematology and Medical Oncology.

Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute

“…sepsis). In such cases, it can be crucial for the spectrum of efficacy of empirical antibiotic treatment to include pathogens with specific resistance [ 142 ], [ 143 ], [ 144 ], [ 148 ], [ 342 ], [ 346 ], [ 347 ], [ 348 ], [ 349 ], [ 350 ], [ 351 ], [ 361 ], [ 362 ], [ 388 ], [ 389 ], [ 390 ], [ 391 ], [ 392 ], [ 393 ], [ 394 ], [ 395 ], [ 396 ], [ 397 ], [ 398 ], [ 399 ], [ 400 ], [ 401 ], [ 402 ], [ 403 ], [ 404 ], [ 405 ], [ 406 ], [ 407 ], [ 408 ], [ 409 ], [ 410 ], [ 411 ], [ 412 ], [ 413 ], [ 414 ]. On the other hand, this must not lead to prolonged uncritical use of reserve antibiotics [ 156 ], [ 415 ], [ 416 ], [ 417 ], [ 418 ], [ 419 ], [ 420 ], [ 421 ].…”

“… That the medical professional associations in the AWMF continue with the progressive development and detailed formulation of existing guidelines on antimicrobial stewardship [ 381 ], [ 382 ] for the different clinical areas in which immunosuppressed patients are treated so that the characteristics of this patient population are given proper consideration [ 148 ], [ 270 ], [ 351 ], [ 408 ], [ 447 ], [ 448 ], [ 449 ], [ 450 ], [ 451 ], [ 452 ], [ 453 ], [ 454 ], [ 455 ], [ 456 ], [ 457 ], [ 458 ], [ 459 ], [ 460 ], [ 461 ], [ 462 ], [ 463 ], [ 464 ], [ 465 ], [ 466 ] (cat. II).…”

Mini Review: Co-Existing Diseases and COVID-19—A One Way Ticket?

“…Despite the lack of data currently available on COVID-19 outcomes in patients with hematologic diseases, a nationwide case analysis from 575 hospitals in China suggested that, in general, immunosuppressive patients were more likely to contract COVID-19 and, most importantly, there was a higher risk of severe events among those patients, including admission to ICUs, need for assisted ventilation and number of death cases [4]. In the spring of 2020, the European Hematology Association presented several issues that challenge the managing of hematologic patients due to a changed work environment, personnel sicknesses, shortages of blood products and patients not receiving adequate therapy within the required time frame in an emergency setting [17]. The EHA experts also suggested that despite the absence of specific data, potential risk factors for severe courses of SARS-CoV-2 infection can be severe immunodeficiency, lymphopenia and long and profound neutropenia.…”

Community-Acquired Respiratory Viruses in Oncology: Lessons to Be Learnt from the SARS-CoV-2 Pandemic

“…As a hematologist with an interest in infectious diseases I would like to use this opportunity to repeat a long-standing message: community-acquired respiratory viruses (CARV) are potential killers, especially for cancer patients [1]. Influenza has long been famous for causing seasonal excess mortality in all populations and is therefore well known as a dangerous pathogen in cancer patients in particular [2, 3].…”