78例老年恶性血液系统疾病医院感染情况分析

Analysis of Nosocomial Infection in 78 Cases of Elder Patients with Hematologic Malignancies

目的 探讨老年恶性血液系统疾病医院感染的状况。方法 对该院 9年内收治的老年恶性血液系统疾病共 78例进行回顾性调查。结果 医院感染率为 5 0 % ,急性白血病 (AL)组感染率 (6 7.4% )明显高于非AL组(2 8.6 % ) ,常见感染部位为呼吸系统 (37% )、败血症 (2 4.1% )、口腔 (14.8% )。病原菌为革兰阳性菌 (43.3% )、真菌 (2 9.7% )和革兰阴性菌 (2 7% )。结论 老年恶性血液系统疾病医院感染发病率高 ,疾病性质、白细胞减少、住院时间长是导致医院感染的重要因素。革兰阳性球菌所致感染居首位 ,应积极采取防治措施。

Objective to investigate the incidence,the factors predisposing to infection,the most infectious agents in elder patients with hematologic malignancies (HM).Methods An investigation was made on 78 elder patients with HM who were hospitalized from jun.1989 to dec.1998.Results Thirty nine cases of nosocomial infection (NI)were found among 78 cases(the percentage was 50%).the nosocomial infection rate (NIR) in patients with actue leukemia was 67.4%,which was 28.6% in patients with non actue leukemia ( P <0.01).The NIR of patients with WBC less than 1.0×10 9/L was 73%,which was 29% in patients with WBC more than or equal to 1.0×10 9/L( P <0.01).The average days in the hospital were 73 for patients with NIR,while it was 32.2 in patients with non NIR. The infection was located mostly in lower respiratory tract(37%),blood (24.1%),mouth ( 14.8 %),uper respiratory tract (11.1%)and digestive tract(7.4%).The etiological examination revealed that the major pathogens of NI were Gram-positive (G +) coccus (43.3)%),fungus ( 29.7 %)and Gram-negative (G -)bacilli (27%)in turn.Conclusions NIR of elder patients with HM is higher than mean NIR, The factors predisposing to infection include the characate of disease,leukopenia and hospitalization for long time.The NI caused by G + coccus are more common than that caused by G - bacilli.The NI caused by fungus have been increasing rapidly.