急性白血病合并医院感染调查分析  

Survey of acute leukemia with nosocomial infections

作　　者：蒋梅英[1] 陈智[2] 王菊芳[1] 嵇菊珍[1] 王春玲[2] 李玉[1] 成玉春[1] 

机构地区：[1]南京医科大学附属淮安第一医院感管处 [2]东南大学医学院,江苏南京210009

出　　处：《中华医院感染学杂志》2012年第18期3973-3975,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨急性白血病(AL)患者医院感染特点,分析引起医院感染的危险因素,为制定医院感染防治措施提供客观依据。方法采用前瞻性与回顾性相结合的方法,对2008-2009年血液科612例AL患者监测资料进行统计分析。结果血液科612例AL住院患者中发生医院感染207例、277例次,感染率为33.8%、例次感染率为45.3%;感染患者中以初治者、难治者及复发者为主,占64.3%;入院时住走廊及>6例大房间者占66.7%;感染部位中呼吸道占首位,感染率为55.2%;病原菌中革兰阴性菌占35.2%、革兰阳性菌占25.9%、真菌占38.9%;感染时患者中性粒细胞计数≤2.0×109/L者占84.1%。结论急性白血病患者中初治、难治及复发者是医院感染的主要人群;中性粒细胞数低下是主要危险因素;呼吸道是重点监控部位;控制加床数、缩短住院日、减少陪护与探视不可忽视,采取积极的全面综合性预防与针对性预防相结合的控制措施,对降低AL患者医院感染发病率、减轻经济负担、延长生存期有重要意义。OBJECTIVE To provide an objective basis for developing the control measures of nosocomial infection by analyzing the characteristics and the risk factors for acute leukemia （AL） with nosocomial infections. METHODS Both prospective and retrospective methods were employed to analyze the monitoring data of 612 AL patients from the department of hematology from 2008 to 2009. RESULTS Among all the 612 AL inpatients, nosocomial infections occurred in 207 cases while the episodes were 277 cases, the infection rate was 33.8% and the infection rate of episodes was 45. 3% ; the predominant groups with infections were those who were newly diagnosed, refractory or relapsed, accounting for 64.3 %;the patients living in corridor or in the rooms which held 6 or more patients accounted 66.7%; respiratory tract infection rate was 55.2%, taking the top shot of all infection sites; among all the pathogens, gram-negative bacteria accounted 35.2%, gram-positive bacteria accounted for 25.9 %, and fungi accounted for 38.9%; the patients whose neutrophil counts were less than 2.0×10^9/L accounted for 84.1 %. CONCLUSION Patients with acute leukemia who are newly diagnosed, refractory or relapsed are the main population for nosocomial infections; low neutrophil count is the main risk factor; the respiratory tract is the intensive monitoring site; to control the extra bed, shorten the hospital stay, reduce accompany and accessing, and take comprehensive targeted prevention measures has great significance in reducing the incidence of AL, easing the economic burden, and prolonging the survival.

关 键 词：急性白血病 医院感染 病原菌 中性粒细胞 

分 类 号：R552[医药卫生—血液循环系统疾病]