Objective: To investigate distribution and drug resistance of pathogens of bloodstream infection in patients with hematological malignancies, in order to provide reference for clinical infection control and treatment.
Methods: The clinical information of blood culture patients in the hematology department of our hospital from January 2016 to December 2021 was reviewed. They were divided into transplantation group and non-transplantation group according to whether they had undergone hematopoietic stem cell transplantation. The types of pathogens and their drug resistance were analyzed.
Results: Two hundred and ninety-nine positive strains of pathogenic bacteria were detected. In the transplantation group, Gram-negative bacteria accounted for 68.5% (50/73), Gram-positive bacteria accounted for 6.8% (5/73), and fungi accounted for 24.7% (18/73). The resistance rate of Escherichia coli to the third-generation cephalosporins was 77.8%, and 11.5% to carbapenems. The resistance rate of Klebsiella pneumoniae to the third-generation cephalosporins was 50.0%, and 56.2% to carbapenems. In the non-transplantation group, Gram-negative bacteria accounted for 64.1% (145/226), Gram-positive bacteria accounted for 31.0% (70/226), and fungi accounted for 4.9% (11/226). Gram-positive bacteria were mainly Enterococcus faecium (6.6%, 15/226) and Coagulase-negative Staphylococci (6.2%, 14/226). The fungi were all Candida tropicalis. The resistance rate of Escherichia coli to the third-generation cephalosporins was 63.8%, and 10.3% to carbapenems. The resistance rate of Klebsiella pneumoniae to the third-generation cephalosporins was 46.3%, and 26.8% to carbapenems.
Conclusion: The types of pathogenic bacteria in bloodstream infection in patients with hematological malignancies are varied. Gram-negative bacteria is the main pathogenic bacteria. The resistance of pathogenic bacteria to antibiotics is severe. Antibiotics should be used scientifically and reasonably according to the detection and resistance of pathogenic bacteria.
题目: 血液恶性肿瘤患者血流感染病原菌分布及耐药性.
目的: 通过分析血液恶性肿瘤患者血流感染病原菌分布及耐药情况，为临床治疗和感染控制提供参考。.
方法: 回顾性分析2016年1月-2021年12月空军军医大学第二附属医院血液科送检血培养患者临床信息，根据是否进行造血干细胞移植将患者分为移植组和非移植组，分析病原菌种类及其耐药情况。.
结果: 检出血培养阳性菌株299株。移植组G-菌占68.5%（50/73），G+菌占6.8%（5/73），真菌占24.7%（18/73）；大肠埃希菌对三代头孢菌素耐药率为77.8%，对碳青霉烯类耐药率为11.5%；肺炎克雷伯菌对三代头孢菌素耐药率为50.0%，对碳青霉烯类耐药率为56.2%。非移植组G-菌占64.1%（145/226），G+占菌占31.0%（70/226），真菌占4.9%（11/226）；G+菌主要以屎肠球菌（6.6%，15/226）和凝固酶阴性葡萄球菌（6.2%，14/226）为主；真菌均为热带念珠菌；大肠埃希菌对三代头孢菌素耐药率为63.8%，对碳青霉烯类耐药率为10.3%；肺炎克雷伯菌对三代头孢耐药率为46.3%，对碳青霉烯类耐药率为26.8%。.
结论: 血液恶性肿瘤患者血流感染病原菌种类多样，G-菌为主要的致病菌，病原菌对抗生素的耐药情况严峻，需根据病原菌检出和耐药情况科学合理地使用抗菌药物。.
Keywords: hematological malignancy; bloodstream infection; drug resistance analysis.