Ma Yating, Wang Shijian, Yang Ming, Bao Jinfeng, Wang Chengbin
Department of Clinical Laboratory, The PLA General Hospital, Beijing 100853, People's Republic of China.
Nankai University School of Medicine, Nankai University, Tianjin 300071, People's Republic of China.
Cancer Manag Res. 2020 Dec 31;12:13579-13588. doi: 10.2147/CMAR.S289291. eCollection 2020.
The incidence of bloodstream infection (BSI) is more common in patients with hematological malignancy. It is important to distinguish infectious episodes from noninfectious episodes. The present study was aimed to describe the epidemiology, clinical indexes, and antibiotic use for in-hospital bloodstream infections of hematological malignancy patients.
Single-center retrospective research was performed on hematological malignancy patients admitted to our hospital from July 2015 to March 2018. Laboratory and clinical information from 322 febrile patients were acquired. These episodes were divided by blood culture results into two groups: 1) blood culture positive-group, 2) blood culture negative-group.
In the 322 febrile cases, 81 (25.2%) patients were blood culture positive, and among them, Gram-negative (G-) bacteria (51.9%) were more isolated than Gram-positive (G+) bacteria (32.1%) and fungi (7.4%). Gram-negative bacteria were more likely to have drug resistance than G+ bacteria. Independent risk factors revealed that patients with complications, high levels of procalcitonin (PCT), glucose, interleukin-6 (IL-6), and d-dimer (D-D), and low concentration of albumin were correlated with the occurrence of BSI. PCT, IL-6 and D-D performed well in differentiating the positive group from the negative group. Moreover, IL-6 and D-D showed excellent performance in differentiating G- and G+ groups, with the areas under the curve all above 0.8.
We analyzed the risk factors for BSI in patients with hematological malignancy, the distribution of bacteria, antibiotic resistance, and the changes in clinical parameters. This single-center retrospective study may provide clinicians insight into the diagnosis and treatment of BSI.
血流感染（BSI）在血液系统恶性肿瘤患者中更为常见。区分感染性发作和非感染性发作很重要。本研究旨在描述血液系统恶性肿瘤患者院内血流感染的流行病学、临床指标及抗生素使用情况。
对2015年7月至2018年3月我院收治的血液系统恶性肿瘤患者进行单中心回顾性研究。收集了322例发热患者的实验室和临床信息。这些发作根据血培养结果分为两组：1）血培养阳性组，2）血培养阴性组。
在322例发热病例中，81例（25.2%）患者血培养阳性，其中革兰阴性（G-）菌（51.9%）的分离率高于革兰阳性（G+）菌（32.1%）和真菌（7.4%）。革兰阴性菌比G+菌更易产生耐药性。独立危险因素显示，有并发症、降钙素原（PCT）、血糖、白细胞介素-6（IL-6）和D-二聚体（D-D）水平高以及白蛋白浓度低的患者与BSI的发生相关。PCT、IL-6和D-D在区分阳性组和阴性组方面表现良好。此外，IL-6和D-D在区分G-菌和G+菌组方面表现出色，曲线下面积均大于0.8。
我们分析了血液系统恶性肿瘤患者BSI的危险因素、细菌分布、抗生素耐药性及临床参数变化。这项单中心回顾性研究可为临床医生对BSI的诊断和治疗提供参考。
