小儿急性淋巴细胞白血病诱导缓解期合并感染的病原菌及耐药性分析  

Analysis on the Pathogenic Bacteria and Drug Resistance of Infections Associated with Acute Lymphoblastic Leukemia at Induced Remission Period in Children

作　　者：陈兴华[1] 秦娜[1] 张晓娟[1] 郭树霞[1] CHEN Xinghua;QIN Na;ZHANG Xiaojuan;GUO Shuxia(Department of Hematology,Zhengzhou People's Hospital,Zhengzhou 450105,China)

机构地区：[1]郑州人民医院血液内科,河南郑州450105

出　　处：《临床医学工程》2020年第2期169-170,共2页Clinical Medicine & Engineering

摘　　要：目的分析小儿急性淋巴细胞白血病诱导缓解期合并感染的病原菌及耐药性。方法回顾性分析我院2016年4月至2018年4月期间收治的60例初治急性淋巴细胞白血病患儿的临床资料,均采取经验性抗感染治疗,根据感染严重程度分成严重感染组与非严重感染组,比较两组的粒细胞缺失出现时期、发热事件发生率、CRP与PCT水平、住院时间。结果 60例急性淋巴细胞白血病患儿中,无临床感染或微生物学感染者18.33%,感染者81.67%,共检出微生物23株,其中G^-菌占43.48%, G^+菌34.78%,真菌占21.74%。严重感染组的粒细胞缺失出现时期在泼尼松试验结束前比例、粒细胞缺失持续时间、CRP水平、住院时间、发热事件发生率均显著高于非严重感染组(P<0.05);两组的PCT水平无统计学差异(P>0.05)。结论急性白血病诱导缓解期常见的感染类型为肺部感染,病原菌以G-菌为主,其次为G+菌、真菌,应根据药敏试验结果给予相应抗感染药物治疗。Objective To analyze the pathogenic bacteria and drug resistance of infections associated with acute lymphoblastic leukemia at induced remission period in children. Methods The clinical data of 60 children with de novo acute lymphoblastic leukemia treated in our hospital from April 2016 to April 2018 were retrospectively analyzed. All children were treated with empirical anti-infection therapy and were divided into severe infection group and non-severe infection group according to the severity of infection. The occurrence period of granulocyte deficiency, incidence of fever events, CRP level, PCT level and hospitalization time were compared between two groups.Results Among 60 children with acute lymphoblastic leukemia, 18.33% had no clinical infection or microbiological infection, and 81.67% had infection. A total of 23 strains of microorganisms were detected, of which 43.48% were G^- bacteria, 34.78% were G^+ bacteria and 21.74% were fungi. The proportion of granulocyte deficiency occurring before the end of prednisone test, duration of granulocyte deficiency,CRP level, hospitalization time and incidence of fever events in the severe infection group were significantly higher than those in the nonsevere infection group(P<0.05);No significant difference was found in PCT level between two groups(P>0.05).Conclusions Pulmonary infection is the most common type of infection in the induced remission period of acute lymphoblastic leukemia. The main pathogen is Gbacteria, followed by G+bacteria and fungi. Anti-infective drugs should be given according to the results of drug sensitivity test.

关 键 词：小儿急性淋巴细胞白血病 诱导缓解期 感染 病原菌 耐药性 

分 类 号：R733.7[医药卫生—肿瘤]