恶性肿瘤患者血流感染的危险因素分析  

Risk factors for bloodstream infections in patients with malignant tumors

作　　者：徐海燕[1] 王延风[1] 冯沙娜 朱宇[2] 刘姗[1] 吴熙[1] 吴晓明[1] 于雷[1] 

机构地区：[1]中国医学科学院肿瘤医院综合科,北京100021 [2]中国医学科学院肿瘤医院检验科,北京100021

出　　处：《中华医院感染学杂志》2016年第5期1014-1016,共3页Chinese Journal of Nosocomiology

基　　金：北京希望马拉松专项基金资助项目(LC2013B36)

摘　　要：目的探讨恶性肿瘤患者发生血流感染的特点及其危险因素,为合理地预防和治疗血流感染提供临床依据。方法选取医院2013年3月-2015年3月150例恶性肿瘤血培养阳性患者为研究对象,对其进行单因素分析及多因素logistic回归分析,筛选出与发生血流感染相关的危险因素,采用SPSS 16.0对数据进行统计分析。结果 150例血培养阳性患者共检出革兰阴性菌83例占52.2%,革兰阳性菌55例占42.8%,真菌8例占5.0%,常见病原菌为大肠埃希菌、表皮葡萄球菌和肺炎克雷伯菌;单因素分析显示,粒细胞缺乏症、机械通气治疗、留置中心静脉导管、Charlson合并症指数以及抗菌药物使用时间≥7d等为恶性肿瘤患者发生血流感染的危险因素(P<0.05),多因素logistic分析显示,留置中心静脉导管以及抗菌药物使用时间≥7d是恶性肿瘤患者发生血流感染的独立危险因素。结论减少有创操作,严格掌握抗菌药物使用时间是降低血流感染发生率的有效方法。OBJECTIVE To explore the characteristics of bloodstream infections in patients with malignant tumors and analyze the risk factors so as to provide guidance for reasonable prevention and treatment of the bloodstream infections.METHODS A total of 150 malignant tumor patients who were positive for blood culture from Mar 2013 to Mar 2015 were recruited as the study objects,then the univariate analysis and multivariate logisticregression analysis were carried out,and the statistical analysis of data was performed with the use of SPSS 16.0software.RESULTS Of 150 patients whose blood specimens were cultured positive for pathogens,83（52.2%）were positive for gram-negative bacteria,55（42.8%）were positive for gram-positive bacteria,and 8（5.0%）were positive for fungi.The Escherichia coli,Staphylococcus epidermidis,and Klebsiella pneumoniae were the common species of pathogens.The univariate analysis indicated that the risk factors for the bloodstream infections included the neutropenia,mechanical ventilation,central venous catheter indwelling,Charlson complication index,and time of use of antibiotics no less than 7days（P〈0.05）;the multivariate logistic analysis showed that the intravenous catheter indwelling and time of use of antibiotics no less than 7days were the independent risk factors for the bloodstream infections.CONCLUSIONIt is an effective way to reduce the invasive operations and strictly control the time of use of antibiotics so as to reduce the incidence of the bloodstream infections.

关 键 词：血流感染 危险因素 肿瘤 病历对照研究 

分 类 号：R730[医药卫生—肿瘤]