Etiological characteristics and clinical outcome of patients with bloodstream infections after allogeneic hematopoietic stem cell transplantation

Zhu Yinting; Song Wen; Ren Yalu; Wu Yining; Xu Jie; Zhu Qiongfang

doi:10.13406/j.cnki.cyxb.003815

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Etiological characteristics and clinical outcome of patients with bloodstream infections after allogeneic hematopoietic stem cell transplantation

Clinical research | 更新时间：2025-12-31

- Etiological characteristics and clinical outcome of patients with bloodstream infections after allogeneic hematopoietic stem cell transplantation
- Journal of Chongqing Medical University Vol. 50, Issue 12, Pages: 1751-1756(2025)
- 作者机构：
  
  苏州大学附属第一医院临床检测中心，苏州 215006
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003815
  CLC： R446.5
- Received：25 January 2025，
  
  Revised：2025-03-02，
  
  Accepted：10 March 2025，
  
  Published：28 December 2025
- 稿件说明：
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朱音婷,宋文,任亚璐等.异基因造血干细胞移植后患者血流感染的病原学特征及临床结果[J].重庆医科大学学报,2025,50(12):1751-1756.

Zhu Yinting,Song Wen,Ren Yalu,et al.Etiological characteristics and clinical outcome of patients with bloodstream infections after allogeneic hematopoietic stem cell transplantation[J].Journal of Chongqing Medical University,2025,50(12):1751-1756.
朱音婷,宋文,任亚璐等.异基因造血干细胞移植后患者血流感染的病原学特征及临床结果[J].重庆医科大学学报,2025,50(12):1751-1756. DOI： 10.13406/j.cnki.cyxb.003815.

Zhu Yinting,Song Wen,Ren Yalu,et al.Etiological characteristics and clinical outcome of patients with bloodstream infections after allogeneic hematopoietic stem cell transplantation[J].Journal of Chongqing Medical University,2025,50(12):1751-1756. DOI： 10.13406/j.cnki.cyxb.003815.

摘要

目的

探讨异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation，allo-HSCT）后患者发生血流感染（bloodstream infections，BSIs）的病原学特征及对患者临床结果的影响。

方法

对2021年至2023年在苏州大学附属第一医院接受allo-HSCT的患者（年龄>14岁）进行回顾性队列研究，分析其人群特点、BSIs病原菌的分布、对常用抗生素耐药性及患者30 d总体生存情况。

结果

1 682例患者在allo-HSCT后，129例（7.67%）患者发生139次BSIs。引起BSIs发作的病原菌为革兰阴性菌（

=98，76.0%）、革兰阳性菌（

=14，10.9%）、真菌（

=7，5.4%）、多微生物（

=10，

7.8%）。在革兰阴性菌中，头孢曲松、头孢吡肟和哌拉西林他唑巴坦耐药株分别为86.2%、68.1%和77.9%。环丙沙星耐药株为57.9%，亚胺培南耐药率为39.4%。在肠球菌属中，青霉素耐药率为93.8%。8株热带念珠菌对氟康唑耐药，对两性霉素B和氟胞嘧啶均敏感。不同类别病原菌引起BSIs患者30 d总体生存率明显差异（

0.001），真菌BSIs患者的30 d总体生存率低于革兰阴性菌（

0.001）、革兰阳性菌（

0.004）和多微生物（

0.013）BSIs患者。真菌BSIs和非霍奇金淋巴瘤与患者较低的30 d总体生存率相关。

结论

揭示了患者在allo-HSCT后BSIs的病原学特征及30 d总体生存情况，为allo-HSCT后BSIs的抗菌治疗和预防策略提供了有力数据支持。

Abstract

Objective

To investigate the etiological characteristics of bloodstream infections（BSIs） in patients after allogeneic hematopoietic stem cell transplantation（allo-HSCT） and their impact on the clinical outcome of patients.

Methods

A retrospective cohort study was conducted among the patients，aged >14 years，who underwent allo-HSCT in The First Affiliated Hospital of Soochow University in 2021-2023，and the patients were analyzed in terms of population characteristics，distribution of pathogenic bacteria for BSIs，resistance to commonly used antibiotics，and 30-day overall survival.

Results

Among the 1682 patients，129 （7.67%） experienced BSIs after allo-HSCT，with 139 episodes in total. The pathogenic bacteria causing BSIs were Gram-negative bacteria in 98 patients （76.0%），Gram-positive bacteria in 14 patients（10.9%），fungi in 7 patients（5.4%），and multiple microorganisms in 10 patients （7.8%）. Among the Gram-negative bacteria，the isolates resistant to ceftriaxone，cefepime，and piperacillin-tazobactam accounted for 86.2%，68.1%，and 77.9%，respectively. The overall drug resistance rates to ciprofloxacin and imipenem were 57.9% and 39.4%，respectively.

Enterococcus

isolates showed a penicillin resistance rate of 93.8%. Eight isolates of

Candida tropicalis

were resistant to fluconazole and were sensitive to both amphotericin B and flucytosine. There was a significant difference in 30-day

overall survival between the patients with BSIs caused by different types of pathogenic bacteria（

0.001），and the patients with fungal BSIs had a significantly lower 30-day overall survival rate than those with Gram-negative bacteria（

0.001），Gram-positive bacteria（

=0.004），and polymicrobial BSIs（

=0.013）. Fungal BSIs and non-Hodgkin’s lymphoma were associated with the relatively low 30-day overall survival rate in patients.

Conclusion

This study reveals the etiological characteristics and 30-day overall survival of patients with BSIs after allo-HSCT，which provides strong support for empirical antimicrobial therapy and infection prevention strategies for patients with BSIs after allo-HSCT.

关键词

Keywords

references

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