中性粒细胞减少型癌症患者患感染的风险较高，尤其是在化疗期间。革兰阴性细菌感染与高死亡率相关。本研究旨在评估白血病成人患者革兰阴性细菌（GNB）血流感染（BSI）的临床特征、结果和流行病学。该单中心回顾性研究包括2017年至2019年间确诊为白血病的102名成人患者。通过电子病历收集患者的人口统计学特征、感染诊断、白血病诊断、合并症和感染结果。最常见的GNB为肺炎克雷伯菌（33.3%）、铜绿假单胞菌（23.5%）和大肠杆菌（17.6%）。此外，36.7%的感染为多重耐药菌感染。最常见的合并症为心血管疾病（36.7%）、糖尿病（33.3%）和肝脏疾病（24.1%）。感染GNB的患者死亡率较未感染的患者高（35.3%和11.8%，p = 0.005）。在多变量分析中，急性髓细胞性白血病和急性淋巴细胞白血病患者更容易发生GNB BSI（p = 0.01），而慢性骨髓细胞白血病和慢性淋巴细胞白血病患者发生GNB BSI的可能性较低。此外，低血红蛋白水平是GNB BSI的独立风险因素（p = 0.001）。化疗药物与发生GNB BSI的风险增加呈关联。急性白血病和低血红蛋白水平的患者患GNB BSI的风险增加，这与死亡率升高有关。需要进行前瞻性研究，进一步评估合并症和化疗药物对不同类型白血病GNB BSI发生的影响。版权所有©2023. 该文章由Elsevier Ltd.发表。保留所有权利。

Patients with neutropenic cancers are at high risk of acquiring infections, especially if on chemotherapy. Gram-negative bacterial infections are associated with high mortality. This study aimed to assess clinical characteristics, outcomes, and epidemiology of gram-negative bacterial (GNB) bloodstream infections (BSI) in adult patients with leukemia.This single-center, retrospective study included 102 adult patients diagnosed with leukemia between 2017 and 2019. The patients' demographics, infection diagnosis, leukemia diagnosis, comorbidities, and infection outcomes were collected from electronic medical records.The most common GNB were Klebsiella pneumoniae (33.3 %), Pseudomonas aeruginosa (23.5 %), and Escherichia coli (17.6 %). Additionally, 36.7 % of infections were multidrug resistant. The most common comorbidities were cardiovascular diseases (36.7 %), diabetes mellitus (33.3 %), and liver diseases (24.1 %). GNB-infected patients had a higher mortality than noninfected patients (35.3 % and 11.8 %, respectively, p = 0.005). In a multivariable analysis, patients with acute myeloid leukemia and acute lymphoid leukemia were significantly more likely to acquire GNB BSI (p = 0.01), while patients with chronic myelogenous leukemia and chronic lymphocytic leukemia had a lower likelihood of developing GNB BSI. In addition, low hemoglobin level was an independent risk factor of GNB BSI (p = 0.001). Chemotherapeutic agents showed an association with increased risk of GNB BSI.Patients with acute leukemia and low hemoglobin levels have increased risk of GNB BSI, which was associated with increased mortality. Prospective studies are needed to further assess the effect of co-morbidities and chemotherapy medications on the occurrence of GNB BSI according to the type of leukemia.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.