Catheter-related Bloodstream Infection Etiology Distribution And Resistance Analysis In Immunocompromised Patients

Background—In recent years,the incidence of catheter-relatedbloodstream infections (CRBSI) increases with the widespread applicationof the central venous catheter. On the other hand, the number of patientswith secondary immunodeficiency is increasing due to the medicaloperations such as organ transplantation and radiochemotherapy. Thesepatients are susceptible to a variety of pathogenic microorganisms, andare subject to suffering from repeated, persistent and severe infection.CRBSIs is one of the severe nosocomial infections. Not only the waste ofmedical resourse, but also the tragic result of the patients will bebrought about after the improper intervention of CRBSIs.. Gram-positivebacteria, which generally recognized as the main pathogenic bacteria inCRBSI, is gradually changing recently according to the results ofepidemiological investigations. As a result, recognition of these rulesof infection is important for efficiently preventing and treating of theCRBSIs. This article focuses on the analysis of etiology characteristicsand drug resistance of CRBSIs in the immunocompromised patients in pastfive years.Methods—The clinical and pathogenic data of the immunocompromisedpatients with CRBSIs from January2008to December2012were analyzedretrospectively.. Clinical data were presented using the standardizedforms. The chi-square test was used to compare different variables withSPSS13.0statistical package.Results—In this study,136cases of immune deficiencies patients with CRBSIs were analyzed retrospectively.142strains of infection wereconfirmed, among which fungus is predominant,following by gram-negativebacteria, and gram-positive bacteria. The top four pathogens in turn arewhite candida, coagulase negative staphylococcus, staphylococcus aureusand acinetobacter baumannii. The distribution of the pathogenic bacteriain patients with CRBSI is significantly different between internalmedicine and surgery (P<0.01). They are also significantly differentbetween the groups of immunodeficient disease with different pathogenesis,and the groups of patients with different indwelling time (P<0.01). Allof the gram-positive bacterium show resistant to penicillin, and partlyresistant to other antimicrobial agents. But the gram-positive resistantto vancomycin and rinathiazole amine have not yet been found. Few ofgram-negative bacteria resistant to quinolone and aminoglycosideantibiotic were found, apart from acinetobacter baumannii which showsmultiple drug resistance. Some of fungi show resistant to fluconazole,voriconazole, itraconazole and5–FC appear, but not amphotericin B.Conclusions—As a result, recognition of the rules of infection in theimmunodeficient patients is important for efficiently preventing andtreating of the CRBSIs.