Profile and Antibiotic Pattern of Blood Stream Infections of Patients Receiving Hematopoietic Stem Cell Transplants in Southwest China

Figures & data

Table 1 Characteristics of Patients After HSCT

Characteristic	All Patients N = 741(%)	Patients with BSI N = 65(%)
Gender
Female	315(42.5%)	31(47.7%)
Male	426(57.5%)	34(52.3%)
Age
Median	40	38
Range	14~66	14–58
Disease
AML	199(26.7%)	21(32.3%)
ALL	120(16.1%)	15(23.1%)
AUL	6(0.8%)	3(4.6%)
HL	26(3.5%)	0
NHL	174(23.3%)	6(9.2%)
CML	25(3.4%)	4(6.2%)
AA	38(5.1%)	6(9.2%)
PNH	4(0.5%)	0
MDS	40(5.4%)	4(6.2%)
MM	93(12.5%)	4(6.2%)
POEMS	13(1.7%)	0
Others	8(1%)	2(3%)
Type of HSCT
Allo-HSCT	376(50.4%)	52(80%)
Auto-HSCT	370(49.6%)	12(18.5%)
Both	4(0.5%)	1(1.5%)
Site of infection
Pulmonary	/	41(63.1%)
Gastrointestinal tract	/	14(21.5%)
Skin and soft tissue	/	3(4.6%)
Endogenous/Unknown	/	7(10.8%)

Abbreviations: BSI, bloodstream infection; HSCT, hematopoietic stem cell transplant; AML, acute myeloid leukemia; ALL, acute lymphoblastic leukemia; AUL, Acute undifferentiated leukemia; HL, Hodgkin lymphoma; NHL, non-Hodgkin lymphoma; CML, chronic myeloid leukemia; AA, aplastic anemia; PNH, paroxysmal nocturnal hemoglobinuria; MDS, myelodysplastic syndromes; MM, multiple myeloma; Allo-HSCT, allogeneic hematopoietic stem cell transplant; Auto-HSCT, autologous hematopoietic stem cell transplant.

Figure 1 The incidence in HSCT patients and overall episodes throughout the years.

Table 2 Changing Prevalence of BSI in Patients After HSCT

	2013	2014	2015	2016	2017	2018	2019	p value
GPB	1	4	3	1	4	2	3	0.725
Enterococcus spp.	1	1	2	1	2	0	2	0.624
Streptococcus spp.	0	2	1	0	0	0	0	0.556
Clostridium spp.	0	0	0	0	0	1	0	0.222
Staphylococcus spp.	0	1	0	0	2	1	1	0.916
GNB	5	10	13	5	8	6	2	0.534
E. coli	2	5	6	4	5	1	2	0.320
P. aeruginosa	1	2	1	1	1	1	0	0.989
Klebsiella spp.	0	0	4	0	2	0	0	0.130
S. maltophilia	1	1	1	0	0	2	0	0.494
Acinetobacter spp.	0	1	0	0	0	0	0	0.735
Enterobacter spp.	1	0	0	0	0	1	0	0.245
Capnocytophaga spp.	0	0	0	0	0	1	0	0.367
Fungi	2	1	0	1	2	1	1	0.630
Polymicrobial	0	1	4	1	0	2	0	0.188

Abbreviations: BSI, bloodstream infection; HSCT, hematopoietic stem cell transplant; GPB, gram-positive bacteria; GNB, gram-negative bacteria.

Table 3 The Overall Distribution of MDR or XDR Microorganism

MDR	N = 37/58
Enterococcus spp.	4/9
Enterobacteriaceae spp.	24/30
Pseudomonas aeruginosa	3/7
Acinetobacter spp.	1/1
Stenotrophomonas maltophilia	3/5
Staphylococcus spp.	2/6
XDR	N = 11/58
Enterococcus spp.	2/9
Enterobacteriaceae spp.	6/30
Pseudomonas aeruginosa	1/7
Acinetobacter spp.	1/1
Stenotrophomonas maltophilia	0/5
Staphylococcus spp.	1/6

Abbreviations: MDR, Multidrug-resistant; XDR, extensively drug-resistant.

Table 4 Carbapenem- or Tigecycline-Resistance in Different Strains

	E. coli (N = 25)	K. pneumoniae (N = 6)	P. aeruginosa (N = 7)	S. maltophilia (N = 5)	E. faecium (N = 7)	A. baumannii (N = 1)
Carbapenem resistance	4	2	2	/	2	1
Tigecycline resistance	2	1	/	0	0	0

Figure 2 The incidence of MDR and overall episodes of MDR or BSI in different years.

Figure 3 The changing incidence and number of ESBL, carbapenem resistance, and tigecycline resistance within the year.

Table 5 Seven- and Thirty-Day Mortality of Different Antibiotics-Resistance

	7-Day Mortality (N = 12)	30-Day Mortality (N = 18)
MDR or XDR	9	14
Carbapenem-resistance	4	7
Tigecycline-resistance	1	3
Fungus	2	3

Abbreviations: MDR, Multidrug-resistant; XDR, extensively drug-resistant.