多发性骨髓瘤合并医院感染患者病原菌耐药特点及肠道菌群的变化OA北大核心CSTPCD

Aim:To analyze the distribution and drug resistance of pathogenic bacteria,and changes of intestinal flora in patients with multiple myeloma(MM)complicated with nosocomial infection.Methods:Data of 151 patients with MM admitted to the Second Affiliated Hospital of Chengdu Medical from May 2020 to May 2023 were collected and analyzed.The samples from the infection site of infected patients were collected for isolation,culture and identification of pathogenic bacteria.Fresh stool samples were collected before and after chemotherapy for intestinal flora analysis.Results:Among 151 patients,97 cases(64.2%)developednosocomialinfection.Fromthe97 cases,113 strainsofpathogenicbacteriawereiso-lated,and Gram-negative bacteria,Gram-positive bacteria and fungal accounted for 63.7%(72/113),30.1%(34/113)and 6.2%(7/113),respectively.Klebsiella pneumoniae was highly resistant to ampicillin and levofloxacin,Pseudomonas aeruginosa was high resistant to ampicillin and gentamicin,Escherichia coli was highly resistant to ampicillin and ceftazi-dime,and all the three strains were sensitive to cefoperazone/sulbactam and imipenem.Staphylococcus aureus was highly re-sistant to penicillin,ampicillin,erythromycin,oxacillin and levofloxacin,Staphylococcus epidermidis was highly resistant to penicillin,oxacillin,erythromycin and ampicillin,and both were sensitive to vancomycin and teicoplanin.After chemothera-py,compared with the non-hospital infected patients,the counts of Escherichia coli and Enterococcus in infected group were significantly more,while the counts of Bifidobacterium and Lactobacillus were significantly less;ACE,Chao1,Shannon and OTU abundance were significantly lower(P<0.05).Conclusion:Patients with MM might be prone to nosocomial infec-tion,and Gram-negative bacteria are the main pathogenic bacteria,and patients with MM and nosocomial infection have ob-vious intestinal flora imbalance.