[Epidemiology and drug resistance of the pathogenic microbes in the complicated infection of hematological malignancies].

OBJECTIVE

To investigate the epidemiological characteristics and drug resistance profile of the infection in patients with hematological malignancies.

METHODS

All the microbe strains isolated from the department of hematology in Ruijin hospital between 1998 and 2002 were collected for the assessment of antimicrobial susceptibility and the results were analysed by WHONET5 software.

RESULTS

Out of the 536 strains isolated in the department of hematology, 230 (42.9%) were Gram positive and 301 (56.2%) Gram negative organisms. The first 6 strains of Gram (-) microbes in frequent order were Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, Escherichia coli, Acinetobacter Baumannii and Stenotrophomonas (xantho) maltophi. The extended spectrum beta-lactamase (ESBLs) producing rates of Escherichia coli and Klebsiella pneumoniae were 27.3% and 33.3%, respectively. Methylcillin resistant coagulase negative staphylococcus (MRCNS) was the most prevalent Gram (+) bacteria in the complicated infection patients with hematological malignancies, which accounted for 88.5%. Carbapenems were most sensitive for all of the gram negative bacteria, with a drug resistance rate of 11.4 (5.0% approximately 15.8%) of imipenem. For ESBLs strains, carbapenems and cefapime were the best choice, with the resistance rate of 46.4% approximately 94.4% and 50.0% approximately 75.9%, respectively. The drug resistance rate of Acinetobacter Baumannii was 25.0% approximately 41.3% for the third generation cephalosporin, 22.7% for the fourth generation cephalosporin and 12.7% for imipenem. Pseudomonas aeruginosa was resistant to carbapenems, with a resistance rate of 12.7% of imipenem; however, it was more sensitive to the third generation cephalosporin.

CONCLUSION

Antibiotics should be rationally administrated with more considerations to the characteristics of epidemiology and drug resistance profile of the microbes in the given department of hematology.