Antimicrobial Resistance Patterns in Infections Among Patients With Hematologic Malignancies: A Systematic Review

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Patients with hematologic malignancies face high infection risks due to neutropenia and intensive treatments.
• Antimicrobial resistance (AMR) complicates infection management in this vulnerable population.
• International data on AMR patterns in hemato-oncology is synthesized to inform clinical practice.

Purpose of the Study:

• To systematically review pathogen distribution and AMR patterns in patients with hematologic malignancies.
• To analyze clinical outcomes associated with infections caused by resistant pathogens.
• To identify evidence gaps and inform future surveillance and treatment strategies.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Google Scholar (2014-2025).
• Inclusion of studies with microbiologically confirmed infections and AMR data in hemato-oncology patients.
• Qualitative synthesis due to heterogeneity in study designs and data.

Main Results:

• Gram-negative bacteria were predominant pathogens, with regional variations.
• High prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (40-78%) and carbapenem-resistant Gram-negative bacteria reported.
• Resistant infections were associated with worse clinical outcomes, including higher mortality.

Conclusions:

• Antimicrobial resistance, especially from Gram-negative bacteria, is a critical issue in hematologic malignancies.
• Strengthened hemato-oncology-specific surveillance and local antibiogram-guided therapy are recommended.
• Standardized reporting of AMR phenotypes and outcomes is crucial for effective management.