急性白血病患者合并院内感染的临床分析

A clinical analysis of acute leukemia with nosocomial infection

目的探讨急性白血病患者合并院内感染的临床特点、危险因素及病原菌种类和耐药情况,为院内感染防治提供依据。方法选取急性白血病患者1 758例,采用回顾性分析的方法对患者院内感染的部位、病原体及相关危险因素进行分析。结果1 758例急性白血病患者中发生院内感染的有658例,感染率为37.42%,感染827例次,例次感染率为47.04%,感染部位以呼吸道,口腔、血液为主,住院天数及中性粒细胞缺乏时间为发生院内感染的独立因素,感染病原菌以革兰氏阴性杆菌为主,基本均对亚安培南敏感。诱导缓解的患者真菌感染比例高于未化疗及巩固治疗患者。结论急性白血病患者院内感染率高,为有效预防院内感染的发生,在保证治疗原发病同时,应缩短住院与中性粒细胞缺乏时间,合理使用抗菌药物。

Objective To investigate the clinical features of nosocomial infection and the characteristics of pathogens and treatment in patients with acute leukemia.Methods A total clinical data of 1 758 cases of acute leukemia patients were collected from acute leukemia in patients,and the risk factors,the site of infection,the pathogens of nosocomial infection in patients with acute leukemia were analyzed.Re-sults The prevalence of nosocomial infection was 37.42% among 1 758 patients,and the prevalence of time-cases was 47.04%.The main infection sites were respiratory tract,oral cavity and blood.The independent factor of nosocomial infection was hospital stays,agranulocytosis duration.The main pathogens were Escherichia coli,Klebsiella and S.aureus.The great majority of Gram-negative bacillus were sensitive to imipenem.The proportion of fungus in induction ease was higher than others.Conclusion Acute leukemia patients are the susceptible popu-lation of nosocomial infection,in our treatment,shortening the hospital stays and agranulocytosis time and rational use of antibiotics can effi-ciently reduce the prevalence of nosocomial infection.