| Objective and significanceBy exploring the classification of pathogenic bacteria,drug resistance and influencing factors of multidrug-resistant organisms(MDROs)infecting hematopoietic stem cell transplantation(HSCT)patients,we will provide a basis for clinical targeting of prevention,control and treatment of pathogenic bacterial infections.MethodsThrough retrospective analysis,we collected the culture,identification results and drug sensitivity test results of pathogenic bacteria,basic information and related influencing factors of HSCT patients in the blood laminar flow ward from January 2021 to December 2022 at Nanfang Hospital,Southern Medical University.The distribution,drug resistance of pathogenic bacteria and individual risk factors of MDROs infection were analyzed.Results1.Distribution of pathogenic bacteria:among the 201 pathogenic strains,Enterococcus faecium(26.8%),Klebsiella pneumoniae(13.4%),Enterococcus faecalis(10.4%),Escherichia coli(8.4%)and Staphylococcus haemolyticus(8.0%)were predominant.2.The site of infection in gram-positive bacteria was predominantly the gastrointestinal tract in 88 cases(77.9%),the site of infection in gram-negative bacteria was predominantly the bloodstream in 41 cases(56.2%).3.Drug resistance of major pathogens:Enterococcus faecium had greater than 55.6%resistance rates to cefoxitin,ampicillin,ciprofloxacin,erythromycin and aminoglycosides,and no more than 18.5%resistance rates to vancomycin,teicoplanin,linezolid and quinupristin-dalfopristin.The resistance rates of Klebsiella pneumoniae to ciprofloxacin,cotrimoxazole,tetracycline and chloramphenicol were all greater than 59.0%,the resistance rates to carbapenems and enzyme inhibitor-containing complexes were no higher than 37.0%,and the susceptibility to amikacin and tigecycline reached 100.0%.The resistance rates of Escherichia coli to cotrimoxazole,tetracycline,chloramphenicol piperacillin,ampicillin and quinlones were all greater than 50.0%,and greater than 90.0%susceptibility to amikacin,tigecycline and carbapenem antibiotics.The resistance rates of Staphylococcus haemolyticus to ampicillin,benzocillin,gentamicin and erythromycin were 100.0%,and the susceptibility to tigecycline,teicolanin,linezolid and vancomycin was 100.0%.4.Analysis of the influencing factors infecting MDROs:univariate Logistic regression analysis showed that MDROs infection were potentially associated with gender,lasting time of using antibacterial drug for no less than 7 days,combined hypoproteinemia and blood transfusion(P<0.2),and multivariate Logistic regression analysis showed that lasting time of using antibacterial drug for no less than 7 days and combined hypoproteinemia were independent risk factors of MDROs infection(P<0.05).Conclusions1.From 2021 to 2022,among the 201 strains of pathogenic bacteria infecting HSCT patients in the blood laminar flow ward at Nanfang Hospital,Southern Medical University,gram-positive bacteria were predominantly Enterococcus faecium,Enterococcus faecalis and Staphylococcus haemolyticus,and gram-negative bacteria were predominantly Klebsiella pneumoniae and Escherichia coli.2.Among the 201 pathogenic strains,the sources of pathogenic bacteria predominantly were feces,blood and anal swabs,and the areas of infection predominantly were the digestive tract and blood.3.The four major MDROs,Enterococcus faecium,Escherichia coli,Klebsiella pneumoniae and Staphylococcus haemolyticus,have high resistance rate to most antimicrobial drugs and dynamic monitoring of resistance is needed to give a basis and insight for the formulation of scientifically appropriate prevention and control strategies.4.Lasting time of using antibacterial drug for no less than 7 days and combined hypoproteinemia are individual risk factors of MDROs infection,and should be targeted by clinicians for prevention and control of MDROs infection. |
