Analysis On Epidemiological Characteristics Of Pathogens Of Infected Patients In Single Center Hematology Department In Recent Ten Years

Objective: The aim was to retrospectively review the epidemiological characteristics of the pathogens in hematology department between 2005 and 2015.Methods: We collected the data included positive culture bacteria from January 2005 to December 2015 and positive culture fungi from January 2013 to December 2015 at General Hospital of Tianjin Medical University.The collected positive bacterial samples were isolated and identified according to conventional methods,And the Drug sensitivity analysis was performed according to the 2014 CLSI standard.Results: 1.The proportion of positive bacteria isolated from patients with hematological malignancies was generally decreased,and the proportion of fungi in the whole hospital remained basically stable over the past three years.2.The main source of pathogens isolated from patients with hematological malignancies was sputum specimens,which were the same as those in the whole hospital,but the proportion of bacterial strains derived from whole blood was significantly higher than that of the whole hospital.3.The overall distribution of bacteria,blood disease patients and patients with infection in the hospital were G-bacteria accounted for the majority,but the main types of strains are different.Compared with the whole hospital,G-bacteria from blood disease patients increased significantly nearly five years,especially Stenotrophomonas maltophilia,Klebsiella pneumoniae and Acinetobacter baumannii.4.Hematology and Candida albicans are the most common fungi strains in clinical isolates from blood disease patients and whole hospital infected patients,but the proportion of patients with hematological infections isolated mold was significantly higher than the level of the hospital.5.The isolation rate of MRSA in patients with hematological infections was generally lower than that of the whole hospital.The isolation rate of ESBL(+)and Klebsiella pneumoniae in patients with hematological infections was close to that of the whole hospital.Inoculation of Enterobacteriaceae(CRE)in penicillin,there is an imipenem-resistant Klebsiella pneumoniae isolated from the sputum samples of patients with hematological infections in 2015.6.(1)Staphylococcus on vancomycin,linezolid in both patients with blood disease or the hospital has always maintained a high sensitivity rate;Staphylococcus aureus on oxacillin,levofloxacin resistance rate In the hospital as a whole showed a slow downward trend,but in patients with blood disease infection rate was increasing year by year trend.(2)Enterococcus,Enterococcus faecium on penicillin G,levofloxacin and tetracycline resistance is higher,and are higher than Enterococcus faecalis,after 2009,patients with hematological infections were no longer isolated from vancomycin-resistant Enterococcus faecium or Enterococcus faecalis.(3)The prevalence of G-Enterobacteriaceae(Escherichia coli,Klebsiella pneumoniae),which is common in patients with hematological infections,is higher than that of amphetamine and nitrofurantoin,Klebsiella pneumoniae resistance to cephalosporins is always higher than the hospital level,in addition,in 2015 from the blood of patients infected with sputum specimens isolated from imipenem-resistant Klebsiella pneumoniae,suggesting that we should pay more attention to the production and control of CRE.(4)Pseudomonas aeruginosa on piperacillin / tazobactam,cefepime,amikacin,gentamicin and ciprofloxacin in patients with blood diseases and hospital infection are maintained a good sensitivity,And these drugs in patients with hematological disease resistance rate is lower than the hospital level,and its resistance to imipenem with Acinetobacter baumanne in recent years has declined,has been lower than the hospital level.Streptomyces hygroscopicus on cefoperazone / sulbactam resistance rate was increasing year by year,higher than the hospital,the new drug resistance rate of nearly 3 years remained below 10%,lower than the hospital resistance Drug rate.Conclusion:(1)The proportion of positive bacteria isolated from the Department of Hematology showed a downward trend in the whole hospital,indicating that the prevention of nosocomial infection in the Department of Hematology has achieved certain results.(2)Department of Hematology due to the particularity of disease and treatment,clinical common pathogens distribution,source and drug resistance are different from the hospital,in the clinical work to master its characteristics are conducive to infection according to symptoms,The monitoring of bacterial resistance changes,so that the application of antibiotics more reasonable and more effective.