Michael Satlin, MD, MS
Associate Professor of Medicine
Associate Professor of Pathology and Laboratory Medicine
Clinical Director, Transplant-Oncology Infectious Diseases Program
Weill Cornell Medicine
About my role in the ARLG
As an ARLG trialist in training, I receive funding, guidance, and mentorship that is allowing me to lead a multicenter study to identify the frequency and clinical significance of colonization with fluoroquinolone-resistant gut bacteria in neutropenic patients. In addition, ARLG has given me the opportunity to participate on the Gram-Negative Subcommittee and Immunocompromised Host Working Group where I can contribute to the development of other clinical trials.
About my research
Patients with hematologic malignancies are uniquely susceptible to life-threatening bloodstream infections from gram-negative gut bacteria when they are neutropenic after chemotherapy. The current standard-of-care is to administer fluoroquinolones prophylactically to prevent gram-negative infections during neutropenia. However, the rising rate of bacterial resistance to fluoroquinolone threatens the effectiveness of this approach.
Our study will determine the frequency of colonization with fluoroquinolone-resistant Enterobacterales in this patient population when they begin chemotherapy. We will also assess whether patients colonized with these bacteria are more likely to develop gram-negative bloodstream infections.
Why is this research important?
The rate of fluoroquinolone resistance has increased dramatically in common Enterobacterales, such as Escherichia coli that cause bloodstream infections in neutropenic patients. The goal of this research is to identify the impact of colonization with fluoroquinolone-resistant gut organisms and identify strategies to improve infection prevention by characterizing the resistance profiles of colonizing enteric bacteria.
We expect that results from this study will lead to the design of a subsequent clinical trial to determine if an individualized approach to antibacterial prophylaxis, where the choice of prophylactic antibiotic is based on the resistance profile of colonizing gut bacteria, lowers the risk of bloodstream infection in neutropenic patients compared to the current standard-of-care of universal fluoroquinolone prophylaxis.
Impact of the ARLG mentoring and funding on my career
I am forever grateful that ARLG’s mentorship and opportunities have allowed me to successfully launch my research career. Senior ARLG members helped to provide the preliminary data for the current study by serving on a Scientific Advisory Board to support my K23 Career Development Award. The mentorship guided my transition from the initial award all the way to becoming an independent investigator. The opportunity to network with leading clinical researchers in the field of antimicrobial resistance has also led to additional collaborative research and grant funding.
ARLG’s training provides unparalleled opportunities to conduct high-impact clinical research in antibacterial resistance and to learn from the leading experts in the field. The funding from ARLG made it possible for me to conduct a multicenter study that will hopefully lay the groundwork for a future trial that could change clinical practice.