Study On The Distribution And Related Factors Of Common Bacteria In Nosocomial Infection In Patients With Hematologic Diseases

Objective:To analyze the incidence of nosocomial infection,influencing factors,distribution characteristics of common bacteria and drug resistance of hematological inpatients in county and city hospitals.Methods:The infectious clinical date of 1350 patients with hematological diseases who were hospitalized in Department of Hematology of Zhucheng traditional Chinese Medicine Hospital(county hospital)from January 2012 to December 2016 were analyzed.By consulting the patient's medical records,collecting the relevant examination results.The basic information of patients and disease related information were collected by questionnaire.The factors of nosocomial infection,the distribution of common bacteria and drug resistance were analyzed.Results:The incidence of nosocomial infection in patients with hematopathy diseases was17.8%.Acute leukemia patients were the most common disease with infection,accounting for 47.1% of the total infected patients,followed by multiple myeloma,accounting for 11.7%.Pulmonary infection was the most common location,accounting for 44.2% of nosocomial infection,followed in order by upper respiratory tract infection(12.5%)and blood stream infection(11.7%),The fourth is skin and soft tissue infection(8.3%).There were 63 Gram-negative strains(68.5% of total bacteria)and 29Gram-positive strains(31.5%)in distribution of infected bacteria.Gram-negative bacteria were mainly Escherichia coli,a total of 17 strains,accounting for 18.5%,which was one of the most common bacteria.11 strains of Klebsiella pneumoniae(12.0%),9 strains of Pseudomonas aeruginosa(9.8%),7 strains of Acinetobacter baumannii(7.6%),6 strains of Enterobacter cloacae(6.5%).The main Gram-positive bacteria distribution in turns is Staphylococcus aureus(8 strains,8.7%),Staphylococcus epidermidis(6 strains,6.5%),In addition,it includes Staphylococcus,Enterococcus faecium,Enterococcus faecalis,and Streptococcus faecalis and so on.The data related to the antimicrobial resistance of bacteria are as follows: 1.Gram-negative bacteria are highly sensitive to ertapenem,imipenem,piperacillin-tazobactam,and cefepime.2.Amoxicillin,piperacillin,levofloxacin and other clinical commonly used antimicrobial resistance is extremely high.3.The resistance rate of Gram-positive bacteria to penicillin was almost 100%.4.Vancomycinand linadine were sensitive to Gram-positive bacteria and no drug-resistant bacteria were found.The factors related to nosocomial infection includes the older the patients,the longer the time of granulocyte deficiency,the longer the length of hospitalization,and use of hormone therapy and chemotherapy.Conclusion: In the county level hospital,The hospitalized patients with hematologic diseases are high risk groups for nosocomial infection.Gram-negative strains is more common(68.5% of total bacteria)than the Gram-positive strains(31.5%)in distribution of infected bacteria.Gram-negative strains and Gram-positive strains have high resistance to antibiotics commonly used.We should use the sensitive antibiotics as much as possible when an empirical drug is used.In view of the above risk factors,effective intervention measures should be established to prevent and control nosocomial infection in patients with hematologic diseases.