儿童恶性肿瘤合并感染病原菌调查

Pathogen Investigation on Infections in Children with Neoplastic Disease

目的了解上海地区儿童恶性肿瘤合并感染的主要病原菌,为临床治疗提供依据。方法收集医院2001年1月-2006年6月儿童恶性肿瘤合并感染并明确病原菌病例共341例次,回顾分析感染部位与病原菌,对比院内与院外、粒细胞缺乏与非粒细胞缺乏的感染。结果血液(49.0%)为最常见的感染部位,病原菌以革兰阴性菌(46.0%)为主;院内与院外感染的部位差异有统计学意义(P<0.05),病原菌差异无统计学意义;粒细胞缺乏与非粒细胞缺乏的感染部位差异有统计学意义(P<0.01),菌血症中细菌类型分布差异有统计学意义(P<0.01)。结论医院病原菌分布与亚洲国家相似,与欧美国家有一定差异。

OBJECTIVE To describe the microbial spectrum of infections in pediatric patients with neoplastic disease in Shanghai and assist pediatricians in the decision of treatment. METHODS We reviewed 341 cases of infection among pediatric cancer patients from Jan 2001 to Jun 2006 and analyzed their infectious sites and pathogens. The infections between inpatients and outpatients, neutropenia and non-neutropenia patients were compared. RESULTS Bloodstream （49%） was the most frequent site of infections, and Gram-negative bacteria （46%） were the commonest organisms. The difference was found in the infectious sites between inpatients and outpatients （P〈 0.05）, but not in that of the organisms. Between neutropenia and non-neutropenia patients, both the infectious sites（P〈0.01） and the organisms （P〈0. 01） were different. CONCLUSIONS The microbial spectrum in our hospital is similar to that reported from Asian trials but different from European and North American ones.