Analysis in pathogenic characteristics and prognostic factors in malignant hematopathy patients complicated with bloodstream infection

Objective To analyze the etiology, drug resistance and prognosis-related risk factors of patients with malignant hematopathy.

Methods The clinical materials such as bacteria distribution and drug resistance of 162 malignant hematopathy patients with bloodstream infection were analyzed retrospectively, and the 30-day mortality was used as the primary endpoint to determine the prognostic factors.

Results A total of 162 strains of pathogenic bacteria were isolated from 162 malignant hematopathy patients with bloodstream infection, including 112 strains of Gram-negative bacteria (69.1%), 42 strains of Gram-positive bacteria (25.9%), and 8 strains of fungus (4.9%). Among the Gram-negative bacteria, the top four were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Enterobacter cloacae subspecies cloacae; a total of 8 cases with carbapenem-resistant Enterobacteriaceae were found, in which carbapenem-resistant Klebsiella pneumoniae accounted for the highest proportion. The total 30-day mortality was 28.4%. Logistic regression analysis showed that the independent predictors for 30-day mortality were disease status, duration of agranulocytosis and Pitt bacteremia score.

Conclusion There are many kinds of pathogenic bacteria of bloodstream infection in patients with malignant hematopathy, and the Gram-negative bacilli is the main type; different pathogenic bacteria have different sensitivities to antibiotics, and antibiotics should be used reasonably according to the distribution and drug resistance of pathogenic bacteria of bloodstream infection in the region.