血液病患者院内感染的临床分析

目的分析血液病患者医院感染的临床特点。方法对1年来该院血液科诊治的1 381例血液病住院患者中发生医院感染的162例进行回顾性分析。结果血液系统疾病的院内感染发生率为11.73%,其中急性白血病感染发生率最高(18.16%),其次是多发性骨髓瘤(16.66%)、淋巴瘤(13.88%);发生院内感染部位以呼吸道感染(包括上下呼吸道)为主共69例(42.59%),发生院内感染的病原菌以大肠埃希菌、铜绿假单胞菌等革兰阴性杆菌(G-)为主,有27株(占58.69%),其中多重耐药菌(MDRO)菌株有13株(占15.43%)。血液病发生院内感染与患者疾病类型、年龄、化疗后白细胞数量等因素具有直接相关性,且易出现MDRO感染。结论及时准确地确诊血液系统疾病的类型,积极治疗原发病,合理使用广谱抗菌药物及粒细胞集落刺激因子(G-CSF),在治疗期间医务人员要加强环境控制及感染源控制,是预防和降低血液病患者发生医院感染的主要措施。

Clinical survey of nosocomial infection in patients with hematologic diseases

Objective To investigate the clinical characteristics of nosocomial infection in patients with hematologic diseases. Methods Totally 1 381 patients with hematologic diseases in our hospital were analyzed retrospectively. Results Among them the incidence of nosoeomial infection was 11.73% ; which was apparently the highest in patients with acute leukemia（ 18.16% ） than with multiple myelo- ma（ 16.66% ）, lymphomas （ 13.88 % ）. The main infection site was respiratory tract （69/1 381 ）. Gram-negative bacteria were the most common pathogens, such as escherichia coli, pseudomonas aeruginosa;ineluding 13 straits of multi-drug-resistant organisms （MDRO）. Disease types, ages, neutropenia were associated with nosocomial infection. Conclusions The main measures to prevent, reduce nosoco- mial infection in inpatients with hematological diseases include prompt diagnosis of disease types ,primary diseases being treated in time, wide spectrum antibiotics being used reasonably, hospital conditions being improved.