AG Busch – Applied Infectious Disease Research in Hematology
Patients with hematological diseases face a markedly increased risk of infectious complications due to both the underlying condition and its intensive therapies. Modern treatments—ranging from chemotherapy and antibody-based approaches to targeted therapies, CAR-T cells, and stem cell transplantation—often lead to prolonged immune suppression and thereby elevate infection risk. Rising antimicrobial resistance has prompted a more restrictive use of antibiotic prophylaxis, while longer phases of cytopenia or immunosuppression still require comprehensive strategies against bacterial, viral, and fungal infections. Difficult-to-treat mold infections and an increasing prevalence of multidrug-resistant organisms pose additional challenges.
In this highly selected population, etiology and courses of infection vary significantly from the general population and comprehensive data is sparse. An important aspect of improving patient care consists of retrospective data analysis to generate information on risk factors, immunosuppressive patterns and course of infection.
To ensure safe and effective care, our work focuses on optimized antimicrobial prophylaxis, Antibiotic Stewardship, decolonization strategies, and individualized therapeutic drug monitoring to reduce toxicity, prevent resistance, and improve patient outcomes.
Group Leader
Team
Current Projects
Optimizing Diagnostic Strategies in Hematological Patients with Pulmonary Infections
Hematological malignancies confer a high risk of pulmonary infectious complications with a wide spectrum of causative agents. Bronchoalveolar lavage (BAL), despite being an established diagnostic procedure, is often met with reluctance in this population with regard to possible complications. We aim to evalute the benefit of BAL assessing diagnostic yield, therapeutic relevance, and safety of BAL in non-ventilated hematological patients. Results of our retrospective analysis guide clinical practice aiming to optimize timing, patient selection and diagnostic procedures.. Our intention is to reduce both over- and undertreatment and minimize latency to accurate therapy for hematologic patients with respiratory events.
Fungal Infections in Hematological Patients – Therapy Optimization and Prophylactic Approaches
We focus on rare invasive fungal infections in immunosuppressed hematological patients, with particular emphasis on mucormycosis and fusariosis. These infections carry substantial morbidity and mortality, posing major challenges especially in stem cell transplant recipients. Through comprehensive retrospective data analysis, the objective is to identify the most effective therapeutic strategies and evaluate key risk factors that may predict treatment responses and patient outcomes. In contributing to international registries such as FungiScope we hope to expand collaborative knowledge and strengthen the evidence base for managing these complex infections.
Therapeutic Drug Monitoring in critically ill Hematological Patients – Focus on Bioavailability, Interactions and Dynamic Dosing
In critically ill hematological patients, anti-infective therapy must account for altered bioavailability, drug interactions, and changes in distribution volume, especially in septic shock. Therapeutic drug monitoring (TDM) helps promptly correct under- or overdosing and align drug levels with the minimal inhibitory concentration of multidrug-resistant pathogens. Our current project focuses on optimizing vancomycin dosing using an app-based tool and preventing breakthrough infections through azole level monitoring.
Antimicrobial Resistance Surveillance – Development of MDR Colonization and associated Blood Stream Infections in Hematological Patients
In recent years, we have observed a significant rise in colonization with multidrug-resistant organisms (MDROs) among patients with hematologic malignancies. Due to immunosuppressive therapies and impaired mucosal barriers, bloodstream infections caused by resistant pathogens remain a major concern. The aim of this project is to examine resistance development under different prophylactic strategies in our department, document the incidence of bloodstream infections with resistant organisms, and correlate these findings with colonization patterns.
Publications
coming soon…