85例儿童异基因造血干细胞移植后早期感染的临床分析

Nosocomial Infections During Early Stage after Allogeneic Hematopoietic Stem Cell Transplantation:A Clinical Investigation of 85 Children Cases

目的探讨儿童患者异基因造血干细胞移植后早期感染的临床特点。方法对儿科2008年10月至2010年7月,进行异基因造血干细胞移植的85例儿童患者,在移植后早期感染的发生部位、感染因素及感染种类等作回顾性分析。结果 85例儿童患者在移植早期82例发生了不同程度的感染,发生率为96.47%。感染部位以口腔黏膜为首位,占54.12%,其次是肺部、胃肠道、皮肤等,未发现感染病灶者3例;移植早期感染种类以细菌为主,合并真菌感染8例,占9.41%。结论儿童患者异基因造血干细胞移植早期感染的发生率高,以革兰阴性菌为主,真菌感染的发生率也明显增高,合理使用抗菌药物、预防真菌感染等是防治异基因造血干细胞移植患者早期感染的重要措施。

Objective To investigate the clinical characters of nosocomial infections in children patients with allogeneic hematopoietic stem cell transplantation（allo HSCT） during the early stage of transplantation.MethoedsThe clinical characters of infections in the early stage after transplantation were analyzed retrospectively in 85 children cases from Oct 2008 to Jul 2010.Results The incidence rate of nosocomial infection in the early stage of transplantation was 96.47%.Nosocomial infection occurred mainly in patients were the oral cavity（54.12%）,respiratory tract,intestinaltract,blood,and skin.No infection focus was seen in 3 cases.The main pathogens of the early stage were microbes,and fungal infection was 9.41%.Conclusion sThere is a higher incidence of nosocomial infection in children patients in early stage after allo HSCT.The pathogens are mainly Gram negative bacteria.There is a higher incidence of fungal infection too.A reasonable antibiotics and preventing the fungal infection are good to control nosocomial infection in children treating with allo HSCT.