Distribution, antimicrobial resistance of pathogens from blood culture, and risk factors for death of children with leukemia

Abstract:

ObjectiveTo observe distribution and antimicrobial resistance of  pathogens from blood culture of children with leukemia, and study risk factors. MethodsFrom September 2013 to November 2016, species and antimicrobial resistance types of 131 strains of pathogens isolated from blood culture of 110 children in a pediatric hematology ward were analyzed, childrens’ clinical data were also analyzed statistically. Results131 strains (5.23%) of pathogens were isolated from 2 505 blood culture specimens, gramnegative bacilli and grampositive cocci accounted for 52.67% and 43.51% respectively, the top 3 pathogens were Escherichia coli (15.27%), Klebsiella pneumoniae (15.27%), and Staphylococcus hominis (12.98%). Gramnegative bacilli were highly resistant to ampicillin, cefazolin, ceftriaxone, and ampicillin/sulbactam, but sensitive to amikacin, cefoperazone/sulbactam, piperacillin/tazobactam, and carbapenems; grampositive cocci had higher resistance to penicillin, oxacillin, erythromycin, and clindamycin, but were sensitive to tigecycline, linezolid, vancomycin, and quinupristin/dalfopristin. Univariate analysis showed that mixed infection, diarrhea, Pseudomonas aeruginosa infection, and Acinetobacter baumannii infection were related to mortality due to bloodstream infection in children with leukemia. ConclusionPathogens causing bloodstream infection in children with leukemia is widely distributed, antimicrobial resistance rate is high, it is very important to take active precaution and rational treatment according to antimicrobial susceptibility testing result.