Drug Resistance And Risk Factors Of ESBLs-producing Escherichia Coli Isolated From Nosocomial Infections In Patients With Hematological Diseases

OBJECTIVE: The drug resistance and risk factors of extended-spectrum beta-lactamases produced by Escherichia coli(ECO)in patients with hematological diseases were retrospectively analyzed to provide evidence for rational drug use in clinic.Methods: Collect the clinical and laboratory data of patients with positive Escherichia coli from November 2015 to June 2018 in our hospital.Through retrospective analysis of the laboratory examination data and clinical data of 42 patients with hematological diseases infected with ECO,the drug resistance of Escherichia coli producing ESBLs and its eight related risk factors were analyzed by single factor chi-square analysis and its possible phase.Logistic regression analysis of risk factors.Results : 1.The detection rate of Escherichia coli in patients with hematological diseases was 27.39%,and the detection rate of ESBLs-producing Escherichia coli was 47.62%,which was lower than that reported in domestic and foreign literatures.2.The resistance rate of Escherichia coli to carbapenem antibiotics was 0.00% in patients with hematological diseases,and the sensitivity rates were as high as 80% for cefoperazone/sulbactam,amoxicillin/clavulanic acid,piperacillin/tazobactam,amikacin and polymyxin respectively.3.Compared with non-ESBLs-producing strains,ESBLs-producing strains showed significant differences in resistance to cephalosporins,penicillins,aztreonam and tetracyclines(P<0.05).4.Multivariate regression analysis showed that ESBLs-producing Escherichia coli in patients with hematological diseases had a good prognosis for NE(> 1.5 ×109/l),with significant difference(P < 0.05).5.There was no significant difference between ESBLs-producing and non-ESBLs-producing strains in hospitalization days,sex,age,chemotherapy,hormone use,history of immunosuppressive agents and antibiotics,and types of hematological diseases.Conclusion: 1.The detection rate of Escherichia coli in patients with hematological diseases was 27.39%.Escherichia coli producing ESBLs was 47.62%.The sensitivity rate to carbapenems was 100%.2.ESBLs-producing strains in patients with hematological diseases showed significant differences in antimicrobial resistance to cephalosporins,penicillins,aztreonam and tetracyclines compared with non-ESBLs-producing strains.3.There were no significant differences between ESBLs-producing strains and non-ESBLs-producing strains in hospitalization days,sex,age,chemotherapy,hormone use,immunosuppressive agents and antibiotic history,and types of hematological diseases.