血液疾病患者医院感染及经验性抗感染治疗分析

Nosocomial Infection in Patients with Hematologic Diseases and its Empirical Anti-infection Therapy

目的了解某院血液疾病患者发生医院感染的临床特点及经验性使用抗生素的合理性。方法回顾性分析某院68例住院血液疾病患者医院感染的部位、致病菌检查结果、中性粒细胞水平及经验性使用抗生素治疗方案。结果 68例医院感染病例中,呼吸道感染最常见,占39.7%;病原学送检率为72.1%,检出的菌株中,G-菌占47.6%,G+菌占23.8%,真菌占28.6%;中性粒细胞缺乏者占61.2%;抗生素使用排名前3位的是碳青酶烯类占83.8%、氨基糖苷类占52.9%及三/四代头孢菌素类占44.1%;抗感染治疗有效率为91.2%。结论血液疾病患者粒细胞缺乏期易出现感染,及时使用广谱抗生素治疗可取得较好疗效,该院经验性抗生素使用较为合理。

Objective To investigate the factors of nosocomlal infections for the patients with hematologic diseases, and analyse rationality of empirical use of antibiotics. Methods 68 patients with nosocomia] infection were analyzed retrospec- tively about hospital infection location、pathogen、neutrophil count and empirial use of antibiotics. Results The common site of nosocomial infection was respiratory. The rate of etiology detecting was 72. 196. In detection of bacterlal strains, G^- bacterium, G^＋ bacterium and fungus occupied 47. 6%, 23.8% and 28. 696 ; 61.2% cases neutropenia. The use of antibiotics in the top three was Carbapenems 83.8%, Aminoglycosides 52. 9%, the three/four generation cephalosporins 44. 1%, efficient reached 91.2%. Conclusion Patients with hematologic diseases were susceptible to infection during neutropenia, the therapy of broad -spectrum antibiotic could get better effect, empirical use of antibiotics is basically rational.