急性白血病化疗后医院感染危险因素分析

目的探讨急性白血病患者化疗后医院感染的临床特点、病原菌分布和危险因素。方法回顾性调查分析2009—2011年在福建省立医院住院化疗的急性白血病患者的医院感染情况。结果 40例急性白血病患者累计接受188个疗程化疗,医院感染率为32.9%。常见感染病种依次为肺炎30.6%、急性咽炎24.2%、血流感染11.3%、口腔感染11.3%和肠道感染8.1%。革兰阴性菌和革兰阳性菌为常见的病原菌。急性白血病患者化疗后医院感染发生率与年龄、糖尿病、中性粒细胞缺乏时间和白血病疾病状态显著相关。结论年龄、糖尿病、中性粒细胞缺乏时间和疾病病情是急性白血病患者化疗后医院感染的重要危险因素,应针对其采取有效的预防措施和重点监护以降低感染率,从而改善患者预后。

Analysis of risk factors for nosocomial infections in acute leukemia patients after chemotherapy

Objective To examine the clinical features,pathogens,and risk factors of nosocomial infections in the patients with acute leukemia after chemotherapy.Methods A retrospective review was conducted to analyze the nosocomial infections in the patients with acute leukemia admitted to our hospital during 2009 to 2011.Results Forty acute leukemia patients were included in this analysis.They received a total of 188 cycles of chemotherapy.The overall incidence of nosocomial infection was 32.9%. The prevalent infection included pneumonia(30.6%),acute pharyngitis(24.2%),bloodstream infection(14.5%),oral infection (11.3%) and intestinal infection(8.1%).Gram-negative and gram-positive bacteria are the major pathogens.The nosocomial infections after chemotherapy were significantly associated with age,diabetes meUitus,duration of neutropenia and disease state in patients with acute leukemia.Conclusions The most important risk factors of nosocomial infection are age,diabetes mellitus,duration of neutropenia and disease state in patients with acute leukemia.Effective preventive measures should be put in place to reduce nosocomial infection so as to improve the outcome of such patients.