肿瘤患儿化疗后细菌感染的临床分析  

Clinical analysis of bacterial infections in children with tumors after chemotherapy

作　　者：杨祺[1] 李朝霞[1] 徐婷[1] 

机构地区：[1]河北医科大学第四医院设备处,河北石家庄050011

出　　处：《中华医院感染学杂志》2014年第17期4359-4360,4365,共3页Chinese Journal of Nosocomiology

基　　金：河北省科学技术厅基金资助项目(20092443)

摘　　要：目的探讨肿瘤患儿化疗后细菌感染的危险因素,制定有针对性的感染干预措施。方法选取2010年7月-2011年7月医院诊治的恶性肿瘤患儿400例,观察肿瘤患儿化疗后细菌感染率及感染部位分布,分析患儿发生感染的危险因素,采用SPSS17.0软件进行统计分析。结果 400例患儿中105例发生感染,感染率为26.3%;其中呼吸道感染比例最高,占48.6%,其次为口腔感染,占17.1%;共检出病原菌105株,前3位病原菌依次为凝固酶阴性葡萄球菌、大肠埃希菌、铜绿假单胞菌,分别占35.2%、27.6%和21.0%;经单因素分析,年龄<3岁、接受侵入性操作、白细胞计数<2×109/L、中性粒细胞<0.5×109/L、住院时间>20d患儿发生感染率显著高于其他患儿,两者差异有统计学意义(P<0.05);经logistic回归分析,住院时间>20d、白细胞计数<2×109/L、中性粒细胞≤0.5×109/L及接受侵入性操作是肿瘤患儿化疗后细菌感染的危险因素。结论医院患儿化疗后细菌感染率较高,住院时间、接受侵入性操作等是导致感染的危险因素,针对上述危险因素进行有效干预,可显著降低肿瘤患儿化疗后细菌感染率。OBJECTIVE To explore the risk factors for bacterial infections in the children with tumors and formulate targeted intervention measures. METHODS A total of 400 children with malignant tumors, who were treated in the hospital from Jul 2010 to Jul 2011, were enrolled in the study, then the incidence of bacterial infections and the infection sites were observed, the risk factors for the infections were analyzed, and the statistical analysis was performed with the use of SPSS17.0 software. RESULTS The infections occurred in 105 of 400 children with the infection rate of 26.3%, among whom the children with respiratory tract infections accounted for 48.6 %, the patients with oral infections 17.1%. Totally 105 strains of pathogens have been isolated; the coagulase-negative Staphylo-coccus, Escherichia coli, and Pseudomonas aeruginosa ranked the top three species of pathogens, accounting for 35.2%, 27.6% ,and 21.0%, respectively. The univariate analysis indicated that the incidence of infections was significantly higher in the children with less than 3 years old, invasive operation, white blood cell counts less than 2 ×10^9/L, neutrophils counts less than 0.5 ×10^9/L, or hospitaliZation duration more than 20 days than in other children, and there was significant difference （P〈0.05）. The logistic regression analysis showed that the hospitalization duration more than 20 days, while blood cell counts less than 2 ×10^9/L, neutrophils counts no more than 0.5×10^9/L, and invasive operation were the risk factors for the bacterial infections in the children with tumors after chemotherapy. CONCLUSION The incidence of bacterial infections is high in the children after chemotherapy; the risk factors for the infections include the hospitalization duration and invasive operation. It is necessary to take effective interventions in response to the risk factors so as to significantly reduce the incidence of bacterial infections in the children with tumors after the chemotherapy.

关 键 词：儿童 肿瘤 化疗 危险因素 

分 类 号：R181.32[医药卫生—流行病学]