Analysis of multi-drug resistant bacteria infection and its drug resistance in severe fever with thrombocytopenia syndrome patients

OBJECTIVE To investigate the characteristics and drug resistance of multiple drug-resistant bacteria co-infection in severe fever with thrombocytopenia syndrome（SFTS） patients. METHODS The results of bacterial detection and drug sensitivity test in SFTS patients hospitalized in the 990th Hospital of Joint Logistic Support Force of the Chinese People′s Liberation Army from 2011 to 2021 were retrospectively analyzed, and the effect of multi-drug resistant bacteria infection on the death outcome of SFTS patients were explored. RESULTS A total of 718 patients with SFTS were included in this study, 278 patients（38.7%） developed bacterial infection, of whom 105 patients were complicated with multi-drug resistant bacteria infection. A total of 385 strains of bacteria cultured from 1278 samples were mainly gram-negative bacteria（74.3%）, including 89 strains of Klebsiella pneumoniae and 47 strains of Pseudomonas aeruginosa. There were 99 strains of gram-positive bacteria, including 17 strains of Staphylococcus aureus and 17 strains of Staphylococcus haemolyticus. There were 129 strains（33.5%） of multidrug resistant bacteria in 385 strains, including 22 strains of K. pneumoniae and 16 strains of Escherichia coil. Gram-negative multi-drug resistant bacteria were highly resistant to ampicillin, ampicillin/sulbactam, gentamicin and piperacillin, and less resistant to compared with apenem and imipenem. Gram-positive multi-drug resistant bacteria were completely resistant to amoxicillin/clavulanic acid, clindamycin, ciprofloxacin and ceftriaxone, and not highly sensitive to any antibacterial drugs that were found so far. Multi-drug resistant bacteria co-infection increased the risk for fatal outcomes in SFTS patients（OR=1.736）. CONCLUSION SFTS patients had a higher risk for bacterial co-infection. High proportion of multidrug-resistant bacteria, resistance to multiple antibiotics and multidrug-resistant bacteria co-infection significantly increased the risk of fatal outcomes. For SFTS patients, microbial culture and drug sensitivity test should be carried out as soon as possible, and antimicrobial therapy should be selected reasonably.