Feature Analysis Of Different Neutrophil Levels On The Distribution Of Pathogens In Bloodstream Infection In Patients With Hematologic Malignancy

Objective:To analyze the distribution and drug resistance of pathogens in bloodstream infection in the department of hematology of Shengjing Hospital for 8 years,To explore the distribution of pathogens in patients with different degrees of neutrophils,so as to provide a theoretical basis for clinical prevention and control infection.Methods:The related data of pathogens in bloodstream infection in the Department of Hematology and the basic condition of patients from January 2014 to December 2021were collected,and the distribution and drug resistance of pathogens were retrospectively analyzed according to different neutrophil levels.Results:According to the inclusion and exclusion criteria,a total of 448 pathogens were positive in blood culture from 372 patients,The top five primary diseases in patients were Acute myelogenous leukemia(40.32%),Acute lymphoblastic leukemia(22.84%),No-Hodgkin lymphoma(12.09%)and Myelodysplastic syndromes(9.67%),Multiple myeloma(8.06%).Pathogens included 275 strains of Gram-negative bacteria(61.38%),132 strains of Gram-positive bacteria(29.46%)and 41 strains of fungi(9.15%).The top three Gram-negative bacteria were Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa,Extended-spectrumβ-lactamase-producing Escherichia coli and Klebsiella pneumoniae were 45 strains(45/78,57.69%)and 20 strains(20/71,28.16%).Carbapenem-resistant Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were 4 strains(4/78,5.12%),6 strains(6/71,8.45%)and 9 strains(9/65,13.84%).The top three Gram-positive bacteria were Coagulase negative Staphylococcus,Staphylococcus aureus,and Enterococcus faecium,and none of them were found to be resistant to linezolid and vancomycin.The fungi were mainly Candida tropicalis,and the resistance rate to Amphotericin B was 5.55%.Gram-negative bacteria are the main bacteria in patients with neutrophils<0.1×10~9/L,accounting for 70.50%.Gram-positive bacteria were the main bacteria in patients with neutrophils≥0.5×10~9/L,accounting for59.80%.The infection rates of Gram-negative bacteria and Gram-positive bacteria have differences with different neutrophil levels.Conclusion:Gram-negative bacteria are the main bacteria in patients with hematologic malignancy,but Gram-positive bacteria are the main bacteria in patients with neutrophils≥0.5×10~9/L.Antibiotics should be adjusted according to the distribution and drug resistance of pathogens in bloodstream infections in the region.