Antibiotics
Empirical Therapy in High-Risk Hematological Patients with Carbapenem-Resistant Enterobacterales Colonization: Real-World Treatment Decisions and Antimicrobial Stewardship Implications
By Parrinello MH, Badalucco Ciotta F, Dell'Acqua R and 11 others.
Abstract
Background/objectives
Carbapenem-resistant Enterobacterales (CRE) colonization is a risk factor for infection in hematological patients, but only a minority of colonized individuals develop invasive disease. This creates a stewardship dilemma between ensuring prompt, appropriate empirical therapy and avoiding unnecessary exposure to novel anti-CRE agents. We aimed to describe real-world empirical treatment decisions in CRE-colonized hematological patients.
Methods
Retrospective single-center observational study including adult hematological patients with documented CRE colonization between January 2021-February 2025. The primary objective was to describe the use of empirical therapy active against the colonizing CRE. Secondary objectives were to evaluate concordant infections (caused by the same species and carbapenemase mechanism as the surveillance isolate) and subsequent de-escalation of CRE-active empirical therapy.