Director, Infectious Diseases Program, University of Maryland Greenebaum Cancer Center Director, Antimicrobial Stewardship to Improve Clinical Outcomes Program, University of Maryland Medical Center
UMMC, Room N9E05
Education and Training
1977 BS (Biochemistry) SUNY at Stony Brook, Stony Brook, New York
1982 MS (Physiology and Biophysics) Albert Einstein College of Medicine, Bronx, New York
1984 M.D. Albert Einstein College of Medicine, Bronx, New York
1984 Ph.D. (Physiology and Biophysics) Albert Einstein College of Medicine, Bronx, New York
Post-Graduate Education and Training
1984-1985 Internship (Medicine) New York Hospital/Cornell Medical Center, Department of Medicine, New York, NY
1985-1986 Residency (Medicine) New York Hospital/Cornell Medical Center, Department of Medicine, New York, NY
1986-1989 Fellowship (Infectious Diseases) Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD
1989 ABIM, Specialty Internal Medicine
1990 ABIM, Sub-Specialty Infectious Diseases
I received my medical and laboratory research training in a joint MD/PhD program at the Albert Einstein College of Medicine funded through a federal MSTP grant. I completed my medicine residency at Cornell Univerity Medical Cneter followed by advanced Infectious IDseases fellowship traing in the Laboratory of Clinical Investigation, NIAID, NIH. Following fellowship in 1989, I joined the faculty as an Assistant Professor in the Division of Infectious Diseases, Department of Medicine at the University of Maryland School of Medicine.
I am currently an Associate Professor in the Division of Infection Diseases with a joint appointment in the University of Maryland Stewart and Marlene Greenebaum Cancer Center (UMGCC). I am the director of the Infectious Diseases Section within the cancer center. My faculty colleagues and I are responsible for clinical management of the frequent and often severe infections that complicate overall treatment of patients with a a variety of cancers and who are bone marrow/stem cell transplant recipients. My section is responsible for day-to-day inpatient and outpatient clinical consultations. Additionally, we develop and update infectious diseases best practice guidelines and algorhythms. We also are embedded in the quality improvement infrastructure of the Cancer Center.
I serve as chair of the Data and Safety Monitoring Quality Assurance Committee (DSMQAC) at the University of Maryland Marlene and Steward Greenebaum Comprehensive Cancer Center (UMGCCC). The DSMQAC is tasked with ongoing reviews of UMGCCC PI-initiated trials and of collaborative clinical trials that do not have their own central DSM's. I have been a member of this committee since 2002 and chair since 2003. My additional relevant safety/quality experience includes my roles as chair of the Veterans Affairs Maryland Health Care System, Baltimore, Research and Development Committee (1998–2001); member of the University of Maryland Medical Center (UMMC) Executive Infection Control Committee and the UMMC Antimicrobial Subcommittee of the Pharmacy and Therapeutics Committee (both since 2000); and director of the UMMC Antimicrobial Stewardship Program (since 2012). The goal of the DSM committee is to maximize safety of patients enrolled in clinical trials offered by the Cancer Center. Several years ago, we implemented just-in-time reviews of UMGCC clinical protocols prior to institutional review board (IRB) annual submissions, which assisted nonexpert IRB members with the daunting task of evaluating complexities of oncological agent side effects, toxicities, and drug interactions. We developed solutions to review the avalanche of external safety data, to assure regulatory compliance, to provide timely feedback to investigators, and to investigate poorly performing studies.
I am the Infectious Diseases physician of the University of Maryland Medical Center Antimicrobial Stewardship to Improve Clinical Outcomes Team (ASCOT) program. The goal of ASCOT is to assist clinical prescribers with best practice/guidline compliant treatment of infections. The ASCOT consists of three ID-trained PharmD's and two ID-trained physicians. We perform daily reviews of antimicrobial orders to assess compliance with infections guidelines, to assist primary clinical providers with infection management, to minimize and avoid antimicrobial toxicities and potential drug interactions, to limit risks of developing antimicrobial resistant infections, to minimize infection-related health care costs, and to assure medical center compliance with CDC, Joint Commission, and CMS regulations that pertain to antimicrobial use and infection treatment.
antimicrobial stewardship, infections in cancer patients, infections in stem cell/bone marrow transplant recipients
- Akpek, G., Mikulski, M., Kleinberg, M., Badros, A., Yanovich, S., Rapoport, A.P. (2011). Cellular Therapy with Sequential Unmanipulated Donor Lymphocyte Infusions in Drug-resistant Cytomegalovirus (CMV) encephalitis. Blood 26:5772-4. (letter to the editor).
- Akpek, G., Uslu, A., Huebner, T., Taner, A., Rapoport, A.P., Gojo, I., Akpolat, Y.T., Ioffe, O., Kleinberg, M., Baer, M.R. (2011). Granulomatous Amebic Encephalitis: An Under-recognized Cause of Infectious Mortality after Hematopoietic Stem Cell Transplantation. Transpl. Infect. Dis. 104:366-73.
- Allen, P.B., Koka, R., Kleinberg, M.E., Baer, M.R. (2013). Scedosporium apiospermum Soft Tissue Infection as the Initial Presentation of Acute Myeloid Leukemia: A Case Report. J. Clin. Oncol. 31:e98-100.
- Thom, K.A., Kleinberg, M., Roghmann, M.C. (2013). Infection Prevention in the Cancer Center. Clin. Infect. Dis. 57:579-85.
- Hess, A.S., Kleinberg, M., Sorkin, J.D., Netzer, G., Johnson, J.K., Shardell, M., Thom, K.A., Harris, A.D., Roghmann, MC. (2014). Prior Colonization is Associated with Increased Risk of Antibiotic-resistant Gram-negative Bacteremia in Cancer Patients. Diag. Micro. Infect. Dis. 79:73-76.
- Bork, J.T., Wilding, E., Claassen, C.W., Johnson, J.K., Kleinberg, M. (2015). Fungal Sinusitis in a 75 Year-Old Neutropenic Cancer Patient. Clin. Infect. Dis. 60:321-2.
- Taremi, M., Kleinberg, M.E., Wang, E.W., Gilliam, B.L., Ryscavage, P.A. (2015). Galactomannan Antigen Detection Using Bronchial Wash and Broncoalveolar Lavage in Patients with Hematologic Malignancies. Ann. Clin. Microbiol. Antimicrob. 14:50-2.
- Doll, M., Kleinberg, M., Kokh, D., Riedel, D.J. (2016). Loss of Virologic Control and Severe Pneumocystis Pneumonia in an HIV-Infected Patient Receiving Chemotherapy for Non-Small Cell Lung Cancer. AIDS Res. Hum. Retroviruses. 32:4-5.
- Heil, E.L., Bork, J.T., Schmalzle, S.A., Kleinberg, M., Kewalramani, A., Gilliam, B.L., Buchwald, U.K. (2016). Implementaion of an Infectious Disease Fellow Managed Penicillin Allergy Skin Testing Service. Open Forum Infectious Diseases. Vol 3:ofw155, https://doi.org/10.1093/ofid/ofw155
Kleinberg M.E. (editor) (2009). Managing Infections in Patients With Hematological Malignancies. part of the Contemporary Hematology Series. Humana Press/Springer Science. New York, NY.
- Kleinberg, M.E., Bow, E.J. 2009. Introduction: Approach to the Patient. in Managing Infections in Patients With Hematological Malignancies. part of the Contemporary Hematology Series, ed. M. Kleinberg, Humana Press/Springer Science. New York, NY.
- Forrest, G. N., Kleinberg, M.E. 2009. Issues in Anti-infective Management. in Managing Infections in Patients With Hematological Malignancies. part of the Contemporary Hematology Series, ed. M. Kleinberg, Humana Press/Springer Science. New York, NY.
I have a strong interest in quality improvement initiatives in my roles as Director of the University of Maryland Medical Center Antimicrobial Stewardship Program and as chair of the University of Maryland Greenebaum Cancer Center Data Safety Monitoring (DSM) Committee. The goal of antimicrobial stewardship is to optimize diagnosis and treatment of infections in UMMC patients by promoting and monitoring clinical best practices. My research interests revolve around developing tools to query the wealth of clinical data stored in the EPIC electronic medical record and using that data to make better informed choices of anti-infectives used to treat infections. In addition, we are developing methods to feedback past prescription behavior to departments and individual physicians for focused education with the goal of optimizing future clincial treatment of infections.
My clinical interests are the infectious complications of patients with cancer treated at the University of Maryland Greenebaum Cancer Center. Cancer patients may be treated with chemotherapy, immune modulators or bone marrow/stem cell transplantation. The host immune system is impaired to varying degrees depending on the type of malignancy and the way in which it is treated. The most profoundly immunosuppressed cancer patients are frequently infected, often by pathogens that are not virulent to people defended by normal immune systems. I am interested in development of methods to optimize treatment of infections in complicated neutropenic patients and in bone marrow/stem cell transplant recipients. The complexity of infection management in these patients defies standard drug/bug models since patients must often be treated empirically for some time before it is possible to make accurate diagnoses. These patients are best treated through algorithm-driven treatment models where treatment choices are reevaluated repeatedly as diagnostic testing data and observations of patients responses are used to refine the initial approaches and to arrive at the best outcomes. New rapid diagnostic methods are introduced continually and their best use in improving treatments in neutropenic and other immune suppressed patients is an exciting area of clinical interest.