Author(s)

Yongfeng Zhao ¹, Ying Liu ¹, Ying Zhu ¹, Min Chen ²

Affiliation(s)

¹ Department of Hematology, The First People's Hospital of Jingzhou, Jingzhou, Hubei, China
² Department of Pharmacy, The First People's Hospital of Jingzhou, Jingzhou, Hubei, China

Corresponding Author

Yongfeng Zhao

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 hematologic patients mainly involve gastrointestinal and urinary tracts, with E. coli being the most common and carbapenem sensitive pathogen. MDR prevalence is high, and lymphocytopenia is an independent risk factor. Clinicians should prioritize susceptibility testing and tailor antibiotics accordingly, especially in patients with low lymphocyte counts.

KEYWORDS

Malignant hematologic diseases; Multidrug-resistant bacteria; Drug resistance; Lymphocyte count

CITE THIS PAPER

Yongfeng Zhao, Ying Liu, Ying Zhu, Min Chen. Analysis of Pathogen Distribution and Drug Resistance Trends in Malignant Hematologic Disease Patients at a Tertiary Hospital in Jingzhou City from 2021 to 2025. MEDS Basic Medicine (2026). Vol. 4, No. 1, 113-120. DOI: http://dx.doi.org/10.23977/medbm.2026.040115.

REFERENCES

[1] Klastersky J, de Naurois J, Rolston K, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines [J]. Ann Oncol, 2016, 27(suppl 5):v111-v118.
[2] Wen Ximao, Ren Nan, Wu Anhua, et al. Analysis of hospital infection data among leukemia patients in the National Hospital Infection Surveillance Network [J]. China Journal of Infection Control, 2006,5(1):29–31.
[3] Tumbarello M, Viale P, Viscoli C, et al. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy[J]. Clin Infect Dis, 2012, 55(7):943-950.
[4] Zhou Wenjing, Ma Xiaoling, Gao Peng, et al. Analysis of pathogen distribution and drug resistance in patients with malignant hematologic diseases [J]. China Journal of Infection and Chemotherapy, 2011,11(4):291-294.
[5] Song Xiaochao, Yang Haifei, Chen Kai, et al. Changes in bloodstream pathogens and drug resistance among patients with malignant hematologic diseases from 2013 to 2018 [J]. Chinese Journal of Hospital Infection Diseases, 2018,28(11):1641–1644.
[6] Freifeld AG, Bow EJ, Sepkowitz KA, et al.Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America [J]. Clinical Infectious Diseases, 2011, 52(4): e56-e93.
[7] Gafter-Gvili A, Fraser A, Paul M, et al. Meta-analysis: antibiotic prophylaxis reduces mortality in neutropenic patients[J]. Annals of Internal Medicine, 2012, 156(5):335-347.
[8] Baccelli F, Averbuch D, Akova M, et al. Epidemiology of resistant bacterial infections in patients with hematological malignancies or undergoing hematopoietic cell transplantation in Europe: A systematic review by the European Conference on Infections in Leukemia (ECIL)[J]. Journal of Infection, 2025, 91(3): 106571.
[9] Sallah YH, Bratti VF, Rafinejad-Farahani B, et al. Antimicrobial resistance in patients with haematological malignancies: a scoping review[J]. The Lancet Oncology, 2025, 26(5): e242-e252.
[10] Stoeva T, Niyazi D, Stoev L, et al. Prevalence of intestinal colonization by multidrug-resistant bacteria and related bloodstream infections in patients with hematological malignancies[J]. Acta Microbiologica et Immunologica Hungarica, 2025, 72(4): 341-349.
[11] Khateb AM, Barefah AS, Radhwi OO, et al. Beyond neutropenia: 14 years analysis of bloodstream infections in hematological malignancies[J]. Journal of Infection and Public Health, 2025,18(11):102948.
[12] Park KH, Jung YJ, Lee HJ, et al. Impact of multidrug resistance on outcomes in hematologic cancer patients with bacterial bloodstream infections[J]. Scientific Reports, 2024, 14(1): 15622.
[13] Yang M, Geng HX, Tai JG, et al. Distribution and Drug Resistance of Pathogens Causing Bloodstream Infection in Patients with Hematological Malignancies[J]. Journal of Experimental Hematology, 2024, 32(2): 583-587.
[14] Mikulska M, Averbuch D, Tissot F, et al. Fluoroquinolone prophylaxis in haematological cancer patients with neutropenia: ECIL critical appraisal of previous guidelines[J]. Journal of Infection, 2018, 76(1): 20-37.
[15] Gustinetti G, Mikulska M. Bloodstream infections in neutropenic cancer patients: A practical update[J]. Virulence, 2016, 7(3): 280-297.
[16] Trecarichi E M, Tumbarello M. Antimicrobial-resistant Gram-negative bacteria in febrile neutropenic patients with cancer: current epidemiology and clinical impact[J]. Current Opinion in Infectious Diseases, 2014, 27(6): 500-510.
[17] Gudiol C, Bodro M, Simonetti A, et al. Changing aetiology, clinical features, antimicrobial resistance, and outcomes of bloodstream infection in neutropenic cancer patients[J]. Clinical Microbiology and Infection, 2013, 19(5): 474-479.

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