血液病患儿院内感染防治

 目的 探讨血液病患儿院内感染的危险因素。方法 对62例院内感染的血液病患儿进行回顾性调查分析。结果 62例患儿共发生79起医院感染，感染部位以呼吸道、消化道及血液系统为主，病原菌主要为革兰阴性菌和真菌，革兰阴性菌对美罗培南（倍能）和头孢吡肟（马斯平）高度敏感（90.48 %和87.13 %）。粒、单核细胞减少、化疗、激素和广谱抗生素的使用为院内感染的主要危险因素。结论 为减少院内感染的发生率，对白细胞尤其是中性粒细胞和单核细胞总数＜1.5×109／L的患儿进行保护性隔离，倍能和马斯平可作为血液病患儿的首选抗生素。

Risk factor analysis of hospital infections in children with hematological diseases

Objective To study the risk factors of hospital infections in children with hematological diseases. Methods A retrospective study was performed in 62 children with hematological diseases. Results 79 times of hospital infections could be found in the 62 cases. The infective positions mainly situated on respi－ratory tract, digestive and blood system. The major infective bacteria were gram-negative bacillus and fungus. Further analysis showed that gram-negative bacillus has high drug sensitivity to Meropenem and Cefepime Dihydrochloride (90.48 % and 87.13 %). The main risk factors of hospital infection were the decreasing of white blood cells, chemotherapy, the usage of hormones and broad spectrum antibiotics. Conclusion Protec－tive isolation to the children with a lower count of white blood cells, especially neutrophils and monocytes ＜1.5×109/L, Meropenem and cefepime dihydrochloride being the first choice of antibiotics are all necessary for reducing the infection rates.