Clinical features and risk factors analysis in children with acute leukemia complicated with multidrug-resistant bloodstream infection / 中国实用儿科杂志

ABSTRACT

OBJECTIVE: To investigate the clinical features and risk factors of multidrug-resistant bloodstream infection in children with acute leukemia. METHODS: The clinical data of 121 blood culture-positive patients with acute leukemia admitted from January 1,2013 to September 30,2018 to Department of Pediatrics,Zhujiang Hospital of Southern Medical University were analyzed retrospectively. RESULTS: Of the 121 patients with acute leukemia infected with bacterial bloodstream,55 were in the multidrug-resistant(MDR)group and 66 in the non-multidrug-resistant(non-MDR)group. There were 31 grampositive bacteria in the MDR group. The top three strains were coagulase-negative Staphylococci,Staphylococcus aureus and Streptococcus mutans. Escherichia coli was the main strain of gram-negative bacteria. Logistic analysis suggested that MDR bloodstream infection was more likely to occur in the patiens with AML(P=0.038;OR 2.505;95%CI 1.036—6.058)and at induction chemotherapy stage(P=0.038;OR 2.226;95%CI 1.045—4.774). Other high-risk factors included neutropenic dysplasia >7 d before fever(P=0.003;OR 3.36;95%CI 1.520—7.428),hemoglobin 7 days,hemoglobin<70 g/L and platelet<20×109/L are risk factors for MDR bloodstream infection. The inflammation response is severe MDR bloodstream infections,which may result in longer anti-infective treatments and a worse prognosis.