儿童急性淋巴细胞白血病诱导缓解期感染的病原菌及耐药情况分析

发布时间：2018-02-11 20:01

本文关键词： 急性淋巴细胞白血病诱导缓解期感染儿童　出处：《中国当代儿科杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨儿童急性淋巴细胞白血病诱导缓解期感染的发生情况,以及病原菌特点及耐药情况,为诱导缓解期感染的预防和治疗提供依据。方法回顾性分析130例初发儿童急性淋巴细胞白血病的临床资料,对诱导缓解期的感染情况、致病菌菌株及耐药菌谱进行分析。结果临床感染和/或微生物感染发生率为76.2%,最常见的感染部位是肺部(46.2%)。严重感染占52.3%,包括60例肺部感染和/或21例败血症。130例患儿中共检出病原菌50株,其中细菌29株、真菌21株,28.5%的患儿至少有1种微生物感染。细菌29株中G-菌19株(65.5%)、G+菌10株(34.5%)。最常见的G-菌为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌,对亚胺培南100%敏感。最常见的G+菌为绿色链球菌,对万古霉素100%敏感。真菌占16.2%,以白色假丝酵母菌最常见。与非严重感染患儿相比,严重感染患儿粒细胞缺乏出现更早、持续时间更长,发热事件的比例和CRP更高,住院天数也更长,差异具有统计学意义(P0.05)。结论肺部感染是儿童急性淋巴细胞白血病诱导缓解期常见的感染;G-菌是最主要的病原菌。使用碳青霉烯类抗生素并适时联合万古霉素或抗真菌药能有效控制严重感染。
[Abstract]:Objective to investigate the incidence of infection in children with acute lymphoblastic leukemia (ALL), the characteristics of pathogenic bacteria and drug resistance in children with acute lymphoblastic leukemia (ALL). Methods the clinical data of 130 cases of primary childhood acute lymphoblastic leukemia were retrospectively analyzed. Results the incidence of clinical infection and / or microbial infection was 76.2. The most common site of infection was lung 46.2. Severe infection accounted for 52.3%, including 60 cases of pulmonary infection and / or 21 cases of septicemia .130 cases. A total of 50 strains of pathogenic bacteria were detected in the children. Among them, 29 strains of bacteria and 21 strains of fungi (28.5%) had at least one microorganism infection. Among the 29 strains of bacteria, 19 strains of G- bacteria were found to be G- bacteria and 10 strains of G bacteria were found to be 34. 5%. The most common G- bacteria were Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa, and the most common bacteria were Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa. It is sensitive to imipenem 100%. The most common G strain is streptococcus green and sensitive to vancomycin 100%. Fungi account for 16.22.The most common bacteria is Candida albicans. Longer duration, higher rates of fever events and CRP, longer hospital stay, Conclusion Pulmonary infection is the most common infection in children with acute lymphoblastic leukemia during remission stage. Use of carbapenem antibiotics combined with vancomycin or resistance. Fungal drugs can effectively control severe infections.
【作者单位】：福建省血液病研究所/福建省血液病学重点实验室/福建医科大学附属协和医院小儿血液科;
【基金】：国家和福建省临床重点专科建设项目资助
【分类号】：R733.71

【相似文献】