急性白血病患者医院感染的临床特点分析  

Clinical characteristics of nosocomial infections in acute leukemia patients

作　　者：周竞奋[1] 陈琰[1] 朱振峰[1] 匡丹[1] 王志清[1] ZHOU Jing-fen;CHEN Yan;ZHU Zhen-feng;KUANG Dan;WANG Zhi-qing(The Third People＇s Hospital of Wuxi, Wuxi, Jiangsu 214041, China)

机构地区：[1]无锡市第三人民医院血液科,江苏无锡214041

出　　处：《中华医院感染学杂志》2018年第7期987-990,共4页Chinese Journal of Nosocomiology

基　　金：无锡市科技指导性计划基金资助项目(CSZOON1217)

摘　　要：目的探讨急性白血病(AL)患者合并医院感染的临床特点。方法选择于2014年2月-2015年12月医院收治的80例AL患者的资料,其中急性淋巴细胞性白血病36例、非M3急性髓细胞性白血病44例。回顾性分析患者的年龄、性别、感染部位、住院时间、相关药物使用情况及治疗前后外周血中白细胞、粒细胞计数,并对患者的病程记录、体温、细菌学检查及相关影像学检查结果等进行详细分析。结果 80例患者中有54例患者发生了医院感染,医院感染发生率为67.5%;累计发生感染57例次,例次感染率为105.6%;感染患者病死率为6.3%,高于未发生感染的病死率为1.3%(P<0.05);57例次感染中,主要以上呼吸道感染为主,其中上呼吸道感染住院时间最短,血液感染的住院时间最长(P<0.05);检出病原菌48株,其中革兰阴性菌23株占47.9%、革兰阳性杆菌17株占35.4%、真菌8株占16.7%;单因素分析结果显示,年龄、住院时间、白细胞计数、化疗阶段及是否合并粒细胞缺乏是患者发生医院感染的相关因素(P<0.05)。结论 AL患者医院感染相关因素较多,应采用相关预防对策及选择合理的抗菌药物、安排合理的住院时间及提高机体粒细胞恢复时间,从而降低AL患者医院感染发生率。OBJECTIVE To investigate the clinical characteristics of nosocomial infections in patients with acute leukemia（AL）.METHODS Eighty patients with acute leukemia admitted in our hospital from Feb.2014 to Dec.2015 were selected,including 36 cases of acute lymphoblastic leukemia and 44 cases of non-M3 acute myeloid leukemia.The patients＇ age,gender,location of infectios,length of stay,the use of relevant drugs and the number of leukocytes and granulocytes in peripheral blood before and after treatment were retrospectively analyzed,and the patients＇ course record,body temperature,bacteriological examination and related imaging inspection results were detailly analyzed.RESULTS A total of 54 out of 80 patients had nosocomial infections,and the infection rate was67.5%.The cumulative incidence of infection was 57 cases,and the rate of infection was 105.6%.The mortality rate of infected patients was 6.3%,which was significantly higher than 1.3% of uninfected patients（P〈0.05）.Among the 57 sub-infections,the main infections upper respiratory tract infections,the hospitalization time of lower respiratory tract infection was the shortest,and the hospitalization time of blood infection was the longest（P〈0.05）.Totally 48 strains of pathogens were detected,including 23 strains of gram-negative bacteria accounting for 47.9%,17 strains of gram-positive bacteria accounting for 35.4%,and 8 strains of fungi accounting for 16.7%.The univariate analysis results showed that the patient＇s age,length of hospital stay,the number of white blood cells,and whether combination of granulocytic deficiency during chemotherapy were related factors of nosocomial infections in patients（P〈0.05）.CONCLUSION There are many factors related to nosocomial infection in AL patients.Therefore,we must take appropriate precautionary measures and reasonable antibacterial drugs for treatment,arrange reasonable length of stay and improve the recovery time of granulocyte,so as to reduce the incidence of nosocomial infections in AL patients

关 键 词：急性白血病 医院感染 临床特点 

分 类 号：R181.3[医药卫生—流行病学]