Abstract: Objective To analyze the clinical characteristics, risk factors and distribution of bloodstream infection pathogens in febrile neutropenic children with acute lymphoma leukemia in Children's Hospital of Shanghai Jiaotong University from Jan.2007 to Dec.2016.Methods Clinical and pathogen data of febrile neutropenic children with acute lymphoma leukemia were retrospectively reviewed and analyzed.Results In total, 312 children with ALL were enrolled into the study, including 1,548 FN cases and 1,700 blood cultures. The occurrence rate of bloodstream infection was 8.2% (127/1,548). Bloodstream infection mortality rate was 9.4% (12/127). Among 127 strains of isolated bloodstream pathogens,Gram-positive bacteria accounted for 51.1% (65/127), Gram-negative bacteria 47.2% (60/127) and fungi 1.5% (2/127). Compared with Gram-positive bacterial bloodstream infection, Gram-negative bacterial bloodstream infection had higher incidence of ANC <0.1×10⁹·L^-1 (P=0.041) and septic shock (P=0.002). Gram-negative bacilli Pseudomonas aeruginosa had an increasing trend of infection. There was no significant increase in drug-resistant gram-negative bacilli.Conclusion Gram-positive bacteria were still the main pathogens of FN bloodstream infection. Coagulasenegative Staphylococcus was the most common pathogen of Gram-positive bacteria, and Escherichia coli was the main pathogen of Gram-negative bacteria. Gram-negative bacterial bloodstream infection is more serious than Gram-positive bacterial bloodstream infection complications, which mostly occurs in the stage of severe granulocyte deficiency. Bloodstream infection combined with septic shock is an independent risk factor for FN death.

Key words: Acute lymphoma leukemia, Bloodstream infection, Children, Febrile neutropenia, Pathogen