摘要
目的研究急性白血病患者化疗期间医院感染的病原学特点及影响因素分析,为急性白血病患者化疗后的护理和感染预防提供参考。方法选取2015年6月-2017年5月于医院治疗的195例急性白血病患者作为研究对象,分析患者化疗后医院感染病原菌分布及耐药性,探究化疗后引起感染的影响因素。结果 195例急性白血病患者共有72例患者发生医院感染,感染率为36.92%,其中以呼吸道感染为主,35例占48.61%(35/72);72例感染患者的临床送检样本,共分离病原菌68株,革兰阴性菌40株,以大肠埃希菌为主,革兰阳性菌有25株,以金黄色葡萄球菌为主,真菌3株均为白假丝酵母;主要病原菌对利奈唑胺、替考拉宁以及头孢米诺敏感性较高;住院时间、化疗持续时间、白细胞计数和中性粒细胞计数为急性白血病患者化疗后发生医院感染的影响因素。结论住院时间、化疗持续时间、白细胞计数和中性粒细胞计数是导致急性白血病患者化疗期间医院感染的影响因素,针对上述因素积极采取有效的预防措施。
OBJECTIVE To explore the etiological characteristics and influencing factors for nosocomial infection in patients with acute leukemia during chemotherapy so as to provide guidance for nursing and prevention of infection in the acute leukemia patients after chemotherapy.METHODS A total of 195 patients with acute leukemia who were treated in hospitals from Jun 2015 to May 2017 were recruited as the study objects.The distribution and drug resistance of the pathogens causing the nosocomial infection after chemotherapy were observed,and the influencing factors for the infection were analyzed.RESULTS Of the 195 patients with acute leukemia,72 had nosocomial infection,with the infection rate 36.92%,35(48.61%)of whom had respiratory tract infection.Totally 68 strains of pathogens were isolated from the submitted clinical specimens of the 72 patients with infection,40 of which were gram-negative bacteria,25 were gram-positive bacteria,and 3 were fungi;Escherichia coli was the predominant species of the gram-negative bacteria;Staphylococcus aureus was dominant among the gram-positive bacteria;all of the 3 strains of fungi were Candida albicans.The major species of the pathogens were highly susceptible to linezolid,teicoplanin and cefminox.The length of hospital stay,chemotherapy duration,white blood cell counts and neutrophil counts were the influencing factors for the nosocomial infection in the patients with acute leukemia after the chemotherapy.CONCLUSIONThe length of hospital stay,chemotherapy duration,white blood cell counts and neutrophil counts are the influencing factors for the nosocomial infection in the patients with acute leukemia during chemotherapy.It is necessary to take effective prevention measures according to the influencing factors.
作者
于巧
张亚琳
林姗姗
梁延芝
李艳
郑玮
YU Qiao;ZHANG Ya-lin;LIN Shan-shan;LIANG Yan-zhi;LI Yah;ZHENG Wei(Qingdao Haici Medical Group,Qingdao,Shandong 266033,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期67-70,共4页
Chinese Journal of Nosocomiology
关键词
急性白血病
医院感染
病原学特点
感染部位
影响因素
Acute leukemia
Nosocomial infection
Etiological characteristic
Infection site
Influencing factor
