Clinical Analysis Of 117 Cases Of Bloodstream Infection In Patients With Hematological Diseases

Objective: To analyze the results of blood culture positive specimens of hematological diseases complicated with bloodstream infection,in our hospital from Jan 2010 to Jan 2017.To understand the distribution characteristics of pathogenic bacteria in bloodstream infection and drug resistance characteristics of common pathogenic bacteria in bloodstream infection,and to analyze clinical and experimental data,so as to provide clinical diagnosis and treatment basis for patients with hematological diseases complicated with bloodstream infection.Methods: to collect the clinical data of blood culture positive patients with bloodstream infection from Jan 2010 to Jan 2017 in department of hematology of our hospital.The characteristics of basic disease,distribution of pathogenic bacteria and drug resistance characteristics were analyzed retrospectively.Results: 1.The pathogenic bacteria of 117 patients with hematopathy and bloodstream infection were mainly gram-negative bacteria,accounting for 61.54%.2.Gram-negative bacteria were mainly Escherichia coli,Pseudomonas aeruginosa,and subspecies of klebsiella pneumonia.They were sensitive to Cefoperazone / Shubatan,carbapenem,piperacillin / tazobactam and Amikacin,and the resistance to ampicillin,amamenin and cephalosporins was higher.Gram-positive bacteria are mainly Staphylococcus human,Staphylococcus epidermidis,Staphylococcus aureus and Staphylococcus haemolyticus.They were sensitive to glycopeptide,linezolid,tigocycline and rifampin,and they were resistant to penicillin,erythromycin,clindamycin,tetracycline and compound neinomamine.3.Methicillin-resistant coagulase-negative staphylococci(MRCNS)accounted for 81.48%(22),methicillin-resistant Staphylococcusaureus(MRSA)accounted for 14.29%,and 47.5% of Enterobacteriaceae produced by extended-spectrum beta-lactamases(ESBL).4.In patients with PICC,the positive rate of Gram-positive bacteria was 37.97%,higher than that of non-PICC patients,but there was no statistically significant difference.5.The related diseases of pathogenic bacteria of bloodstream infection were mainly concentrated in AML,ALL,NHL,MDS,AA,MM,etc.Among them,AML49 cases(41.88%),and ALL30 cases(25.64%),and NHL10 cases(8.55%),and AA 8 cases(6.84%),and MDS 6 cases(5.13%).6.Of the patients with hematopathy combined with bloodstream infection,97 were patients with granulocytic deficiency,accounting for 82.91% of the patients with bloodstream infection(P < 0.01).Conclusion: 1.The main pathogenic bacteria of bloodstream infection in patients with hematopathy are gram-negative bacteria,and the first three are: escherichia coli,pseudomonas aeruginosa,klebsiella pneumoniae,subspecies of klebsiella pneumoniae,which are low in the carbapenem,cefoperazone/sulbatan,perazilin/tazobactam,and can be used as an antibacterial agent for the treatment of the treatment.The first three of gram-positive bacteria were: staphylococcus,epidermal staphylococcus,staphylococcus aureus,low drug resistance rate of glycopeptide and linazolamide,and the first choice of antimicrobial agents for the bloodstream infection of gram-positive bacteria.2.The patients with hematopathy combined with bloodstream infection are mainly concentrated in patients with acute leukemia,lymphoma and other malignant hematologic diseases,and most of them occur in the absence of granulocytes,which is related to the lack of time and degree of granulocytes.