摘要
Purpose:To investigate the epidemiology,causative pathogen antibiotic susceptibility,and mortality risk factors of bloodstream infection(BSI)in patients with hematological malignancies(HMs).Methods:Single-center retrospective analysis of BSI cases in patients with HMs in a Chinese tertiary hospital from 2012-2019.Results:Among 17,796 analyzed admissions,508 BSI episodes(2.9%;95%confidence interval:2.6%-3.2%)were identified.Of 522 resulting isolates,326(62.5%)were Gram-negative,173(33.1%)were Gram-positive.The BSI incidence among patients with different HMs(severe aplastic anemia:6.7%;acute leukemia:6.2%;myelodysplastic syndrome:3.2%;multiple myeloma:1.3%;and lymphoma:1.0%)differed significantly(p<0.001).The BSI incidence was significantly higher in the hematopoietic stem cell transplantation(HSCT)group(10.2%)than in the non-HSCT group(2.5%;p<0.001).Escherichia coli(30.7%,160/522)was the most common pathogen,followed by Coagulase-negative staphylococci(19.4%,101/522)and Klebsiella pneumoniae(10.0%,52/522).,The rates of imipenem resistance for E.coli,K.pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii were 6.4%,15.0%,27.8%,and 79.0%,respectively.All the Gram-positive pathogens were linezolid susceptible.Three vancomycin-resistant Enterococcus species were isolated.The overall 14-day mortality was 9.8%(95%confidence interval:7.2%-12.4%).A multivariate analysis showed that HM subtype severe aplastic anemia,A.baumannii,and malignancy non-remission were independent 14-day mortality risk factors.Conclusions:Gram-negative bacteria were the most common pathogens,with E.coli as the predominant strain,causing BSIs in HM patients.A carbapenem-resistant A.baumanni with a high mortality rate in HM patients made empirical antimicrobial choice a highly challenging issue.