Prevalence and risk factors of Gram-negative bacilli causing blood stream infection in patients with malignancy
Prevalence and risk factors of Gram-negative bacilli causing blood stream infection in patients with malignancy
复制标题
DOI：
10.15537/smj.2016.9.14211
复制
发表时间：
2016-09-01
影响因子：
1.6
通讯作者：
Alrabiaa, Abdulkarim A.
中科院分区：
文献类型：
--
作者：
Al-Otaibi, Fawzia E.;Bukhari, Elham E.;Alrabiaa, Abdulkarim A.
目的：了解血液系统或实体器官恶性肿瘤患者革兰氏阴性菌(GNB)的流行病学、危险因素及耐药性。方法：对利雅得哈立德国王大学医院肿瘤科收治的56例GNB菌血症患者进行回顾性分析。2013年1月至2015年10月期间，沙特阿拉伯王国。结果：恶性血液病30例(54%)，实体瘤26例(46%)。最常见的血液系统恶性肿瘤是白血病23例(77%)，其次是淋巴瘤6例(20%)。实体瘤中，结直肠癌9例(34.6%)，乳腺癌6例(23%)。病原菌以大肠埃希菌为主(29.5%)，其次为鲍曼不动杆菌(18%)。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的比例为34.6%。铜绿假单胞菌/鲍曼不动杆菌对亚胺培南的耐药率较高(52.4%)。多重耐药率为43.5%。与菌血症相关的危险因素有ICU入院(32.1%)、术后(23.2%)和中线放置(21.4%)。总的30d死亡率较高(32.1%)。结论：从本院恶性肿瘤患者中分离的GNB耐药率较高，建议根据药敏试验慎重选择抗菌药物治疗。
Objectives: To evaluate the epidemiology, risk factors, and antibiotic resistance of Gram negative bacteria (GNB) in patients with hematologic or solid organ malignancies.Methods: This is a retrospective study of 61 episodes of GNB bacteremia occurring in 56 patients with malignancy admitted to the Oncology Units in King Khalid University Hospital, Riyadh. Kingdom of Saudi Arabia during the period from January 2013 to October 2015. Data were retrieved from the computerized database of the microbiology laboratory and the patient's medical records.Results: Hematological malignancies accounted for 30 (54%) and solid tumors accounted for 26 (46%). The most common hematological malignancies were leukemia 23 (77%), followed by lymphoma 6 (20%). Among solid tumors, colorectal cancer 9 (34.6) and breast cancer 6 (23%) were the most common. The most predominant pathogen was Escherichia coli (E. coli) (29.5%) followed by Acinetobacter baumannii (A. baumannii) (18%). The extended-spectrum beta-lactamases producers rate of E. coli and Klebsiella pneumonia was (34.6%). Imipenem resistance among Pseudomonas aeruginosa/A. baumannii was high (52.4%). The multi-resistant organisms rate was (43.5%). Risk factors associated with the bacteremia were ICU admission (32.1%), post-surgery (23.2%), and placement of central line (21.4%). The overall 30-day mortality rate of the studied population was high (32.1%).Conclusion: In light of the high resistant rate among the GNB isolated from malignancy patients from our institution, careful selection of antimicrobial treatment based on antimicrobial susceptibility testing is recommended.