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

Background: Bloodstream infection (BSI) is a serious medical issue causing non-relapsed mortality in patients receiving hematopoietic stem cell transplantations (HSCT). Methods: The characteristics of all patients receiving HSCT (autologous and allogeneic HSCT) in our hospital from 2013 to 2019 were studied. Ratios, medians, and ranges were calculated to describe categorical variables. Chi-square tests were performed to compare the difference between ratios. Results: A total of 741 patients receiving 746 HSCT procedures-including 376 allogeneic, 370 autologous, and four of both types-were included in the study. The overall incidence of BSI in post-transplantation patients was 8.8% (N = 65). Gram-negative bacteria were the most common strains each year (33.3-81.3%), and E. coli was the most frequently isolated (33.3%). Enterobacterales represented 64.9% of multidrug-resistant (MDR) bacteria, and the ratio of MDR rebounded from 25% to 100% within a year. A total of 27 patients died from BSI after HSCT, and the seven-day and 30-day death tolls were 12 and 18, respectively. MDR caused 63% of deaths among patients with BSI and the mortality rate caused by tigecycline-resistance was as high as 100%. Conclusion: Our results reveal the changing epidemiology of BSI and antibiotic resistance in patients receiving HSCT in Southwest China, as well as showing that MDR and tigecycline-resistant microorganisms should be given more attention. Thus, long-term routine microorganism epidemiological and resistance monitoring in patients undergoing HSCT should be a vital practice in future.