血液病患儿医院感染的临床特点和病原学特征及药敏结果分析

Analysis of the Clinical Features,Etiological Characteristics and Drug Sensitivity of Hospital Infection in Children with Hematologic Diseases

目的:分析血液病(HD)住院患儿医院感染(NI)的临床特点、病原学特征及药敏结果,为防控NI提供科学依据。方法:收集2014-2018年发生NI的217例次HD患儿的临床资料、送检的临床标本培养分离病原菌及药敏实验结果,分析各年度HD患儿的NI率、原发感染部位、检出的主要病原体及药敏结果。结果:HD住院患儿NI发生率3.57%,2018年最低(3.03%),2017年最高(4.34%),不同年份检出率差异有统计学意义(P<0.001);NI住院HD患儿原发感染部位以下呼吸道为主(占27.19%),其次是血液系统(占19.82%);发生NI的HD住院患儿标本中致病菌检出率44.72%,革兰阴性菌居首位,以大肠埃希菌和肺炎克雷伯杆菌为主,药敏结果显示均对碳青霉烯类抗生素较敏感,对头孢菌素类抗生素、氨曲南大部分耐药。结论:HD患儿NI发生率较高,感染部位以下呼吸道为主,革兰阴性菌是NI的主要菌种。

Objective:To analyze the clinical features,etiological characteristics and drug sensitivity of hospital infection in children with hematological diseases(HD)to provide scientific basis for prevention and control of nosocomial infection(NI).Methods:The clinical data of 217 HD children with NI in 2014-2018 were collected.The clinical samples were cultured to isolate pathogenic bacteria and drug sensitivity test results,and the NI incidence,primary infection location,main pathogenic bacteria detected and drug sensitivity results were analyzed.Results:The incidence of NI was 3.57%,the lowest in 2018(3.03%)and the highest in 2017(3.34%).The difference of NI detection rates in different years was statistically significant in(P<0.001).The primary infection was mainly in the lower respiratory tract(27.19%),followed by the blood system(19.82%),and the detection rate of pathogenic bacteria was 44.72%in the samples of HD inpatients with NI,which was mainly Escherichia coli and Klebsiella pneumoniae.The ressuts of drug sensitivity showed that they were sensitive to carbapenem antibiotics and resistant to most of cephalosporins and aztreonam.Conclusion:The incidence of NI in children with HD is high,mainly in the respiratory tract below the infection sites,gram-negative bacteria is the main strain of infection.