白血病患儿医院感染危险因素分析  

Risk factors for nosocomial infections in children with leukemia

作　　者：葛延瑱 王晓霞[1] 曹振霞[1] 师玉晶[1] 马方方[1] 

机构地区：[1]聊城市人民医院儿科一病区,山东聊城252000

出　　处：《中华医院感染学杂志》2015年第10期2340-2342,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技厅基金资助项目[JB(S)2014-3-14B-3]

摘　　要：目的探讨白血病患儿医院感染的临床特征及相关危险因素,为临床干预提供理论依据。方法选择2010年8月-2014年10月医院收治的257例白血病患儿作为研究对象,采用ATB细菌鉴定仪进行病原菌鉴定及药敏试验,应用单因素分析和多因素logistic回归分析对医院感染的相关危险因素进行分析;采用SPSS 17.0软件进行统计分析。结果 257例白血病患儿中发生医院感染78例,感染率为30.35%;感染部位以上呼吸道为主,占30.77%,其次为下呼吸道和胃肠道,分别占25.27%和14.29%;共分离病原菌113株,排前4位病原菌依次为大肠埃希菌、柠檬酸杆菌属、表皮葡萄球菌、肺炎克雷伯菌,分别占21.24%、15.93%、10.62%、9.73%;单因素分析结果显示,住院时间、WBC、NEU、PLT、Hb、IgG、IgM、IgA与白血病患儿医院感染具有相关性(P<0.05);多因素logistic回归分析结果显示,住院时间、IgG、IgM、IgA、WBC、NEU、PLT是白血病患儿发生医院感染的独立危险因素。结论白血病患儿医院感染的发生率较高,常见感染部位为呼吸系统及消化系统,常见病原菌为肠杆菌科细菌与葡萄球菌属;骨髓抑制及继发性免疫缺陷是白血病患儿发生医院感染的主要原因,临床可采取针对性的干预措施,有效降低白血病患儿医院感染率。OBJECTIVE To explore the clinical characteristics of nosocomial infections in the children with leukemia and analyze the related risk factors so as to provide theoretical basis for clinical intervention .METHODS A total of 257 children with leukemia who were treated in the hospital from Aug 2010 to Oct 2014 were recruited as the study objects ,then the pathogens were indentified by using ATB bacterial identification system ,the drug susceptibility testing was performed ,the related risk factors for the nosocomial infections were analyzed by means of the univari‐ate analysis and multivariate logistic regression analysis ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The nosocomial infections occurred in 78 of 257 children with leukemia with the in‐fection rate of 30 .35% ,of whom 30 .77% had the upper respiratory tract infections ,25 .27% had the lower re‐spiratory tract infections ,and 14 .29% had the gastrointestinal tract infections .Totally 113 strains of pathogens have been isolated ;the Escherichia coli ,Citrobacter ,Staphylococcus epidermidis ,and Klebsiella pneumoniae ranked the top four species of pathogens ,accounting for 21 .24% ,15 .93% ,10 .62% ,and 9 .73% ,respectively . The univariate analysis showed that the incidence of nosocomial infections in the children with leukemia was associ‐ated with the length of hospital stay ,WBC ,NEU ,PLT ,Hb ,IgG ,IgM ,and IgA （P〈0 .05）;the multivariate logistic regression analysis indicated that the length of hospital stay ,IgG ,IgM ,IgA ,WBC ,NEU ,and PLT were the independent risk factors for the nosocomial infections in the children with leukemia .CONCLUSION The inci‐dence of nosocomial infections is high in the children with leukemia .The respiratory system and digestive system arethecommoninfectionsites,andtheEnterobacteriaceaeandStaphylococcusspparedominantamongthepatho‐gens .The bone marrow suppression and secondary immunodeficiency are the leading causes of nosocomial infec‐tions in the children with

关 键 词：白血病 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]