Prevalence Of Bacterial Infection Pathogens And Analysis Of The Patients’ Clinical Features In A Single-center Hematology Non-bone Marrow Transplant Ward From2010to2012

OBJECTIVE To investigate the incidence, pathogens and clinical features of infection in consecutive cases from2010to2012in Peking Union Medical College Hospital.METHODS The incidence, pathogen, treat and outcome of patients with hematological diseases who had positive findings of bacterium in their samples from2010to2012were retrospectively analyzed.RESULTS There were449positive samples from4890patients during that period, which accounted for5.8%of all the samples. There were388samples proved to be pathogenic bacteria. Samples separated from patients undergoing community infections make up8.4%of all positive samples. Gram negative bacteria occupied a large proportion of community infections, and none multidrug resistant bacteria had been observed. Samples separated from patients with nosocomial infections account for91.6%of all positive samples. Sputum (49.4%) and peripheral blood (32.6%) were the most common samples to have positive results. Skin, soft tissues (10.4%) and urine (3.7%) were subordinate common samples. Most of the pathogenic bacteria of the nosocomial infection were Gram negative(66.9%). The most common Gram negative bacteria included Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia, while Staphylococcus aureus, Enterococcus faecium and Staphylococcus epidermidis are the most common Gram posiive bacteria. Gram negative bacteria consist most of sputum samples and peripheral blood samples. Samples from the surface of skin wound and anal swab were composed largely by Gram positive bacteria(63.8%). Detection rates of extended-spectrum beta-lactamase(ESBL)-producing Klebsiella pneumonia and Klebsiella oxytoca, Escherichia coli, Proteus mirabilis were24%,87.9%and38.4%, respectively. The resistance of Acinetobacter baumannii is serious. Multidrug-resistant, extensively drug resistant and pan drug resistant A. baumannii count for74%of the total A. baumannii. Stenotrophomonas maltophilia showed low resistance to sulfamethoxazole/trimethoprim, levofloxacin and minocycline.22Methicillin-resistant Staphylococcus aureus and9Methicillin-resistant Staphylococcus Epidermidis were detected, which were only sensitive to vancomycin, teicoplanin and linezolid. All patients were treated in the haematology wards and most of them were under agranulocytosis or immunosuppression.22patients reached clinical recovery through anti-infective therapy, whereas49patients died. Among those deaths,42patients attributed to severe infection and infection associated complications.14of all the deaths might be infected with drug-resistance bacteria. There were61 samples proved to be bacteria colonization. Nonfermenters such as Acinetobacter baumannii and Stenotrophomonas maltophilia made up for a large amount of bacteria colonization.CONCLUSIONS The pathogens of nosocomial infection in hametology ward are most likely G-bacteria. The incidence and pathogens varies from different infection sites. Nosocomial infection still has a higher mortality rate. Once nonfermenters were detected positive, whether pathogenic or colonial should be distinguished.