Gao H Z, Luo L T, Lu L H, Zheng X Y, Yang T, Hu J D
Fujian Medical University Union Hospital, Fuzhou 350001, China Nanping First Hospital of Fujian Medical University, Nanping 353000, China The Second Hospital of Fujian Medical University, Quanzhou 362000, China.
The Second Hospital of Fujian Medical University, Quanzhou 362000, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Nov 14;45(11):1028-1034. doi: 10.3760/cma.j.cn121090-20240824-00319.
This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies. This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection. Logistic regression analysis revealed that hospitalization days of >50 days (=0.010, =3.581, 95% 1.356-9.457), history of antibiotic exposure (=0.008, =4.394, 95% 1.358-6.238), more than two courses of chemotherapy before infection (=0.006, =2.911, 95% 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively (=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) (=0.039, =5.286, 95% 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.
本研究旨在探讨血液系统恶性肿瘤患者铜绿假单胞菌感染的临床特征及预后。本研究回顾性分析了2019年1月1日至2021年12月31日在血液科住院的197例并发铜绿假单胞菌感染的血液系统恶性肿瘤患者的临床资料。根据患者对碳青霉烯类药物的敏感性将其分为敏感组（CSPA感染组）和耐药组（CRPA感染组），比较两组临床特征的差异，并分析CRPA感染的危险因素及预后。Logistic回归分析显示，住院天数>50天（P = 0.010，β = 3.581，95%CI 1.356 - 9.457）、抗生素暴露史（P = 0.008，β = 4.394，95%CI 1.358 - 6.238）、感染前化疗超过两个疗程（P = 0.006，β = 2.911，95%CI 1.358 - 6.238）是发生CRPA的独立危险因素。CRPA组和CSPA组患者的死亡率分别为12.8%（18/140）和28.1%（16/57）（P = 0.010）。Logistic回归分析显示，血流感染（BSI）（P = 0.039，β = 5.286，95%CI 1.091 - 25.621）是血液系统恶性肿瘤患者因CRPA感染死亡的独立危险因素。住院天数>50天、抗生素暴露史以及感染前化疗超过2个疗程是CRPA感染的独立危险因素。CRPA感染的血液系统恶性肿瘤患者死亡率较高，其中BSI是CRPA感染的血液系统恶性肿瘤患者30天死亡率的独立危险因素。
