Clinical characteristics and drug tolerance for infection in patients with agranulocytosis and fever in Shanghai

Abstract

The characteristics of distribution of Pseudomonas aeruginosa in patients with agranulocytosis and fever in 12 hospitals in Shanghai from 2012 to 2014 were retrospectively analyzed. WHONET 5.6 software was used to analyze the results of drug sensitivity test. Data from different diseases, different sample sources, and drug sensitivity tests were statistically analyzed to investigate the clinical distribution characteristics and drug resistance of Pseudomonas aeruginosa in patients with agranulocytosis and fever in Shanghai, China. This study revealed that, among these 109 strains of P. aeruginosa , they were mainly found in patients with acute myelocytic leukemia (AML; 48 strains, 44.04%) and patients with acute lymphocytic leukemia (ALL; 36 strains, 33.03%). The specimen sources were mainly respiratory tract secretions (58 strains, 53.21%) and blood (21 strains, 19.26%). The P. aeruginosa isolates from neutropenic sepsis patients showed high sensitivity to the following antibiotics: piperacillin/tazobactam, cefepime, ciprofloxacin, ceftazidime, and amikacin with 91.1%, 89%, 89%, 87.9%, and 85.7% of isolates being sensitive, respectively. Furthermore, for P. aeruginosa isolates from the AML group of patients, the lowest antibiotic resistance rates were seen for ciprofloxacin (0%), cefoperazone/sulbactam (2.1%), and cefepime (7.1%), while for the ALL group the lowest antibiotic resistance rates were seen for piperacillin (2.8%), ceftazidime (2.8%), and cefepime (2.8%). Isolates from AML patients (21.3%) were significantly more likely to be piperacillin resistant than those from the ALL patients (2.8%). Therefore, P. aeruginosa infection is relatively common in patients with agranulocytosis and fever. The strains had a certain degree of resistance to commonly used antibiotics.