Analysis of Pathogen Distribution and Drug Resistance Trends in Malignant Hematologic Disease Patients at a Tertiary Hospital in Jingzhou City from 2021 to 2025
Abstract
: This study aims to investigate the pathogen distribution, antimicrobial resistance profiles, and risk factors for multidrug-resistant (MDR) infections in patients with malignant hematologic diseases, so as to inform empirical therapeutic decisions. A retrospective analysis of 168 infected patients (168 isolates) was performed. Susceptibility was tested by disc diffusion or automated systems per CLSI. Infection sites, pathogen profiles, resistance rates, and MDR detection were assessed. Univariate and multivariate logistic regression identified MDR risk factors, with ROC curve evaluation. The most frequent infection sites were anal swabs (32.7%) and urinary tract (30.4%), followed by bloodstream (13.7%) and respiratory tract (13.1%). The top four pathogens were Escherichia coli (E. coli) (41.7%), Enterococcus faecalis (11.3%), Staphylococcus epidermidis (7.7%), and Klebsiella pneumoniae (7.7%). E. coli exhibited high resistance to sulfonamides, levofloxacin, cefazolin, and cefoperazone-sulbactam (64.3-71.4%), but remained highly susceptible to meropenem (resistance 4.29%). MRSA was detected in 6.7% and was susceptible to vancomycin, linezolid, and tigecycline. The overall MDR detection rate was 30.36%, with ESBL-producers accounting for 88.2%. Multivariate analysis revealed that lower pre-infection lymphocyte count was an independent protective factor against MDR infection (OR = 0.170, 95% CI: 0.032 – 0.891, P = 0.002), with an AUC of 0.793. Infections in malignant…
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