白血病住院患儿的抗菌药物用药分析

目的 分析急性白血病患儿感染发生情况和抗菌药物的使用情况.方法 对2011年新疆维吾尔自治区人民医院儿科收治的200例白血病患儿感染情况和抗菌药物使用情况进行回顾性分析.结果 我院急性白血病患儿感染的发生率为72.5％(145/200),当白血病患儿WBC≤1×109/L时,感染发生率为69.0％ (116/168),住院时间＞30 d时,其感染率为83.6％(61/73).检出病原菌以革兰阴性杆菌为主,感染部位以呼吸道最多,占74.2％.抗菌药物以三代头孢菌素选择频次最多,占29.9％.白血病患儿发生感染与自身外周血中性粒细胞下降水平和患儿入院时间的长短等因素相关(P＜0.05或P＜0.01).结论 急性白血病患儿感染率高,感染发生与患儿治疗阶段等因素有关,应在治疗原发病的同时,合理使用抗生素,以有效降低感染的发生率.

Analysis of children with ieukaemia after using antibacterial drugs

Objective To analyze the clinical features of nosocomial infection and the usage of antibiotics of pediatric patients with leukemia. Methods Nosocomial infection predisposing factors were analyzed retrospectively in 200 pediatric leukemia patients who were admitted to hospital during 2011. Results The hospital acquired infec- tion rate of pediatric patients with leukemia was 72.5% （145/200）. The infection rates of pediatric patients with leukemia were 80.0% and 83.6% （61/73） respectively when the peripheral WBC counts were less than 1 ~ 109/L and the patients＇duration of hospital stay were more than 30 d. The mainly pathogens were Gram-negative aerobic bacteria. The most common infective sites respectively were ： Upper respiratory tract with infection rate of 74.2%. Three generation cephalosporins were most commonly used, the frequency of use was 29.9%. Infection in children with leukemia was related with the level of their peripheral blood neutrophils decreasing and the stay time of children inthe hospital （P 〈 0.05 or P 〈 0.01 ）. Conclusions Pediatric patients with leukemia have high nosocomial infec- tion rate. It reveals that this infection in pediatric leukemia patients is related to the patients＇duration of hospital stay, peripheral WBC counts. The standardzed antibiotic usage can help to reduce the nosocomial infection