Clinical Analysis Of Single Center Of Drug-resistant Bacteria Infection In Hematological Patients

ObjectiveTo investigate the incidence and clinical characteristics of drug-resistant bacteria infections in hematological patients.MethodsTo retrospectively analyze the clinical data of patients with hematological diseases complicated with multidrug resistant infections from January 2016 to December 2017 in the Department of Hematology of the Fujian Union Medical College Hospital,and to formulate a unified questionnaire for the cases of drug-resistant bacterial infections in hematology patients.The clinical data were categorized and summarized and analyzed using SPSS 22.0 statistical software.Results1.The separated pathogens amounted to 2931 in hematology department of our hospital from January 2016 to December 2017.Gram-negative bacteria was 2025caces(69.09%),while the cases of Gram-positive bacteria and funguses was 865(29.51%)and 41 caces(1.40%)respectively.In this study,there were 737 strains of drug-resistant gram-negative strains(36.40%),including Escherichia coli?Klebsiella pneumoniae and Pseudomonas aeruginosa respectively.There were 438 drug-resistant gram-positive strains(50.64%),including Staphylococcus aureus?Enterococcus faecium and Staphylococcus epidermidis respectively.The main site of multidrug-resistant bacteria infection was respiratory tract,followed by blood stream?skin mucous membrane.Drug-resistant gram-positive bacteria were common in blood stream infections,while drug-resistant gram-negative bacteria were common in respiratory tract infections.2.The risk factors for multi-drug resistant bloodstream infections were related to age,basic disease,and neutropenia.Age?60,patients with hematological malignancies were more likely to have bloodstream infections.The median neutrophils infection rate of multidrug resistant strains was 0.05(0.00-5.84)×10~9/L,and the median neutrophils infected with other multidrug resistant bacteria were 0.38(0.00-8.84).)×10~9/L.The occurrence of drug-resistant gram-positive bacteria bloodstream infection was more common in patients with agranulocytosis.The median CRP of 78.2 mg/L in patients with multi-drug resistant bloodstream infection was 9-10 folds of normal,and the median value in PCT was 1.44 ng/ml,which was 28-29 folds of normal.The incidence of septicemia should be warned when CRP and PCT increased several times.Whether it was a drug-resistant gram-negative bacteria,a drug-resistant dram-negative bacteria or a mixed infection,the high incidence of infection was malignant hematopathy.The highest incidence of infection was acute leukemia.Enterococcus intestinal infection was more common in hematopoietic stem cell transplant(HSCT)patients.3.In this study,staphylococcus aureus was common in drug-resistant gram-positive bacteria in bloodstream infection,skin soft tissue and venous catheter infection.Staphylococcus accounted for 74.8%in blood stream infection,and 66.6%in venous catheter and skin soft tissue infection.Drug-resistant gram-positive bacteria are mainly enterococcus in the intestinal tract and urinary system.Enterococcus accounted for94.1%in the intestinal tract,and 76.9%in urinary system.ConclusionIn this study,Gram-negative bacteria were the predominant pathogens causing hematological patients infection.Drug-resistant gram-positive bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa respectively.Age?60,patients with hematological malignancies were more likely to have bloodstream infections.The occurrence of drug-resistant gram-positive bacteria bloodstream infection was more common in patients with agranulocytosis.The incidence of septicemia should be warned when CRP and PCT increased several times.