Clinical characteristics of bloodstream infections in patients with acute leukemia and treatment strategies
Author(s): ZHANG Guang-ji, LI Wei, LIN Dong, LIU Bing-cheng, WEI Hui, WANG Ying, LIU Kai-qi, GONG Ben-fa, WEI Shu-ning, LIU Yun-tao, GONG Xiao-yuan, QIU Shao-wei, ZHAO Xing-li, GU Run-xia, SU Dong, MI Ying-chang, WANG Jian-xiang, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences
Pages: 3959-3962
Year: 2016 Issue: 17
Journal: Chinese Journal of Nosocomiology
Keyword: Leukemia; Bloodstream infection; Pathogen; Neutropenia;
Abstract: OBJECTIVE To explore the clinical characteristics of bloodstream infections in patients with acute leukemia(AL),analyze the distribution and drug susceptibility of pathogens,and observe the effects of antibiotics.METHODS The characteristics of bloodstream infections in 227 AL patients who were treated in the hospital from Jan 2010 to Jul 2012 were retrospectively analyzed,and a case control study was conducted to observe the treatment outcomes.RESULTS The patients without clear focal infections accounted for 8.1%,most of them were complicated with symptom of infections,of whom 31.4% had pulmonary infections,26.9% had perianal infections,17.5% had gastrointestinal tract infections,16.7% had oral infections,9.2% had upper respiratory tract infections,and 7.8% had skin and soft tissue infections.Among the isolated pathogens,there were 269(74.7%)strains of gram-negative bacteria,80(22.2%)strains of gram-positive bacteria,and 11(3.1%)strains of fungi.The drug susceptibility rates of the Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa to imipenem,cefoperazone-sulbactam,and piperacillin-tazobactam varied from 70.0% to 90.0%;the Acinetobacter baumannii strains were resistant to multiple antibiotics.The gram-positive bacteria and fungi remained extremely susceptible to the commonly used antibiotics.Of the 269case-times of bloodstream infections caused by the gramnegative bacteria,243 were effective for the treatment,with the effective rate 90.3%.Of the 80case-times of bloodstream infections caused by the gram-positive bacteria,76 were effective for the treatment,with the effective rate 95.0%.Of the 11case-times of bloodstream infections caused by the fungi,9were effective for the treatment,with the effective rate 81.8%.CONCLUSION The gram-negative bacteria remain dominant among the pathogens causing the bloodstream infections in the AL patients.It is necessary for the hospital to adjust the drug administration based on the result of the drug susceptibility testing so as to raise the success rare of treatment and reduce the mortality rate.
Pages: 3959-3962
Year: 2016 Issue: 17
Journal: Chinese Journal of Nosocomiology
Keyword: Leukemia; Bloodstream infection; Pathogen; Neutropenia;
Abstract: OBJECTIVE To explore the clinical characteristics of bloodstream infections in patients with acute leukemia(AL),analyze the distribution and drug susceptibility of pathogens,and observe the effects of antibiotics.METHODS The characteristics of bloodstream infections in 227 AL patients who were treated in the hospital from Jan 2010 to Jul 2012 were retrospectively analyzed,and a case control study was conducted to observe the treatment outcomes.RESULTS The patients without clear focal infections accounted for 8.1%,most of them were complicated with symptom of infections,of whom 31.4% had pulmonary infections,26.9% had perianal infections,17.5% had gastrointestinal tract infections,16.7% had oral infections,9.2% had upper respiratory tract infections,and 7.8% had skin and soft tissue infections.Among the isolated pathogens,there were 269(74.7%)strains of gram-negative bacteria,80(22.2%)strains of gram-positive bacteria,and 11(3.1%)strains of fungi.The drug susceptibility rates of the Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa to imipenem,cefoperazone-sulbactam,and piperacillin-tazobactam varied from 70.0% to 90.0%;the Acinetobacter baumannii strains were resistant to multiple antibiotics.The gram-positive bacteria and fungi remained extremely susceptible to the commonly used antibiotics.Of the 269case-times of bloodstream infections caused by the gramnegative bacteria,243 were effective for the treatment,with the effective rate 90.3%.Of the 80case-times of bloodstream infections caused by the gram-positive bacteria,76 were effective for the treatment,with the effective rate 95.0%.Of the 11case-times of bloodstream infections caused by the fungi,9were effective for the treatment,with the effective rate 81.8%.CONCLUSION The gram-negative bacteria remain dominant among the pathogens causing the bloodstream infections in the AL patients.It is necessary for the hospital to adjust the drug administration based on the result of the drug susceptibility testing so as to raise the success rare of treatment and reduce the mortality rate.
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