血液病患者医院感染分析与干预措施

Nosocomial infections in patients with blood diseases

目的了解血液病患者医院感染的发病特点、病原菌及危险因素,采取干预措施。方法采用前瞻性调查方法,对无锡人民医院2009年1月至2009年12月血液病患者的医院感染情况进行调查分析。结果医院感染率为12.93%,例次感染率为15.34%,感染部位以下呼吸道为首位。医院感染的病原菌中革兰阴性菌占68.82%,真菌占21.50%,革兰阳性菌占9.68%。恶性白血病、接受放疗、化疗、免疫受损、白细胞<1.5×109/L时医院感染发生率明显增高。结论血液病患者医院感染率高,应针对其危险因素进行重点监控,并采取有效的预防控制措施,降低其感染率。

Objective To analyze the characteristics,pathogens and risk factors of nosocomial infections in blood disease patients.Methods A prospective investigation was performed among patients with blood diseases from January to December,2009.Nosocomial infections were recorded and analyzed statistically.Results 1 956 blood disease patients were included in the study.The rates of nosocomial infections were 12.93% and 15.23% by patients and by cases,respectively,for blood disease patients.Lower respiratory tract infection was among the most reported cases.The pathogens of infections were confirmed as Gram-negative bacteria（68.82%,64/93）,Gram-positive bacteria（9.68%,9/93） and fungi（21.5%,20/93）,etc.The nosocomial infections were associated with leukemia,recent radiation and chemotherapy,immune injury and leukocyte〈1.5×10^9 in blood disease patients.Conclusion It is efficient to take effective preventive measures against nosocomial infections for blood disease patients with leukemia,recent radiation and chemotherapy immune injury and the low level of leukocyte.