Clinicaland Bacteriologicalanalysis Of Neutropenic Acute Leukemia Patients With Bacteria Bloodstream Infections

Objective: To retrospectively analyze the clinical characteristics,etiology and drug susceptibility of neutropenic acute leukemia(AL)patients with bacteria bloodstream infections in our hospital.Methods: Clinical data,etiology and drug susceptibility of neutropenic acute leukemia patients with bacteria bloodstream infections from April 2008 to April 2018 were retrospectively analyzed.Results: A total of 376 strains were isolated from 2008 to 2018.289 strains(76.9%)was Gram-negative bacteria and 87 strains(23.1%)was Gram-positive bacteria.Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae were listed the top three of Gram-negative bacteria.The composition of Pseudomonas aeruginosa increased from 45.1% to 54.9% in the past 5 years(P< 0.05).The susceptibilities of Escherichia coli and Klebsiella pneumoniae to the tigacycline were 100%,to imipenem were 98.2%-98.3%,and to meropenem were 94.4%-98.1%.The susceptibility of Gram-positive bacteria to glycopeptide antibiotics,linezolid and tigacycline was 100.0%.Among patients with Gram-negative bacteria bloodstream infection,the adjustment rate of early empirical use of non-carbapenems was 74.3%,and that of early empirical use ofcarbapenems was 3.8%(P < 0.05).A total of 304(87.9%)cases of bacterial bloodstream infection improved after anti-infection treatment.Conclusion: 1.Gram-negative bacteria was the majority type of bacteria in neutropenic AL patients with bacteria bloodstream infections.Pseudomonas aeruginosa bloodstream infection showed a growing trend.2.The susceptibility of Gram-negative bacteria to the carbapenems was high,and the treatment adjustment rate was obviously low.Glycopeptide antibiotics,linezolid and tigacycline were effective in treating Gram-positive bacteria infections.