Six-year retrospective analysis of the epidemiology and risk factors of multidrug-resistant bloodstream infections in oncology patients in Jiangxi, China

A retrospective study at Jiangxi Cancer Hospital (2019–2024) analyzed bloodstream infections (BSIs) in 954 cancer patients (1,095 episodes, 1,161 isolates). Gram-negative bacteria dominated (62.8%), mainly E. coli (40.9%) and K. pneumoniae (19.1%), while Gram-positives (37.2%) were led by S. aureus (26.2%). Infection patterns varied by cancer type and invasive procedures. High resistance was seen to ampicillin, piperacillin, cefazolin, and erythromycin; tigecycline and nitrofurantoin showed low resistance. Among isolates, 5.5% were carbapenemase producers, 15.4% ESBL-producers, 36.0% of S. aureus were MRSA, and 66.8% of coagulase-negative staphylococci were methicillin-resistant. MDR occurred in 40.2% of Gram-negatives and 50.9% of Gram-positives. Hypoproteinemia was an independent risk factor for MDR Gram-negative BSIs (OR 3.2). The findings underscore the high MDR burden in oncology patients and the need for tailored therapy and ongoing surveillance.