Epidemiology and Characteristics of Antibiotic Resistance of ESKAPE and E. coli Bloodstream Infections in Patients with Hematological Malignancies: High ESBL and Carbapenem Resistance in a 5-Year Single-Center Retrospective Study.

OBJECTIVE

To analyze epidemiology and characteristics of antibiotic resistance of ESKAPE and Escherichia coli bloodstream infections (BSI) in hematological malignancy patients.

METHODS

Retrospective study of ESKAPE and Escherichia coli BSI cases for 5 years at Shanxi Bethune Hospital. Species identification used MALDI-TOF MS, and susceptibility testing followed CLSI guidelines. Carbapenemase phenotype was confirmed by mCIM/eCIM. Chi-square tests compared resistance and mortality used SPSS27.0.

RESULTS

Among 180 isolates, Gram-negative bacilli were predominated (162/180, 90.0%), including 74 Escherichia coli, 49 Klebsiella pneumoniae and 22 Pseudomonas aeruginosa. Among Gram-positive cocci, Enterococcus faecium accounted for 12 isolates and Staphylococcus aureus for 6 isolates. ESBL rate was 44.1% in Escherichia coli significantly higher than in Klebsiella pneumoniae (36.8%, p = 0.466). Carbapenems showed higher activity against Escherichia coli overall (meropenem 87.5%), but susceptibility was lower in Klebsiella pneumoniae (66.7%) and Pseudomonas aeruginosa (68%). CRKP mortality was 36.4% vs 10.5% for CSKP (p = 0.063). MRSA rate was 50% (3/6); one VREfm isolate was detected.

CONCLUSION

Multidrug-resistant Enterobacterales remain the most significant threat to hematological tumor patients, with CRKP requiring particular attention. Vancomycin and linezolid maintain high activity against Enterococcus faecium and Staphylococcus aureus.