白血病患儿医院感染危险因素分析

发布时间：2018-06-10 10:12

本文选题：白血病 + 医院感染　；参考：《中华医院感染学杂志》2015年10期

【摘要】：目的探讨白血病患儿医院感染的临床特征及相关危险因素,为临床干预提供理论依据。方法选择2010年8月-2014年10月医院收治的257例白血病患儿作为研究对象,采用ATB细菌鉴定仪进行病原菌鉴定及药敏试验,应用单因素分析和多因素logistic回归分析对医院感染的相关危险因素进行分析;采用SPSS 17.0软件进行统计分析。结果 257例白血病患儿中发生医院感染78例,感染率为30.35%;感染部位以上呼吸道为主,占30.77%,其次为下呼吸道和胃肠道,分别占25.27%和14.29%;共分离病原菌113株,排前4位病原菌依次为大肠埃希菌、柠檬酸杆菌属、表皮葡萄球菌、肺炎克雷伯菌,分别占21.24%、15.93%、10.62%、9.73%;单因素分析结果显示,住院时间、WBC、NEU、PLT、Hb、IgG、IgM、IgA与白血病患儿医院感染具有相关性(P0.05);多因素logistic回归分析结果显示,住院时间、IgG、IgM、IgA、WBC、NEU、PLT是白血病患儿发生医院感染的独立危险因素。结论白血病患儿医院感染的发生率较高,常见感染部位为呼吸系统及消化系统,常见病原菌为肠杆菌科细菌与葡萄球菌属;骨髓抑制及继发性免疫缺陷是白血病患儿发生医院感染的主要原因,临床可采取针对性的干预措施,有效降低白血病患儿医院感染率。
[Abstract]:Objective to investigate the clinical characteristics and related risk factors of nosocomial infection in children with leukemia and to provide theoretical basis for clinical intervention. Methods from August 2010 to October 2014, 257 children with leukemia were selected as study subjects. The pathogen identification and drug sensitivity test were performed by ATB bacteria identification instrument. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of nosocomial infection, and SPSS17.0 software was used to analyze the risk factors of nosocomial infection. Results there were 78 cases of nosocomial infection in 257 children with leukemia, the infection rate was 30.355.The infection was mainly in the upper respiratory tract (30.7777), followed by the lower respiratory tract (25.27%) and the gastrointestinal tract (14.29%). 113 strains of pathogenic bacteria were isolated. The top four pathogens were Escherichia coli, Bacillus citrate, Staphylococcus epidermidis and Klebsiella pneumoniae, accounting for 21.24% 15.933.10.62% and 9.73.The results of univariate analysis showed that the main pathogens were Escherichia coli, Staphylococcus epidermidis and Klebsiella pneumoniae. Logistic regression analysis showed that the length of stay in hospital was an independent risk factor for nosocomial infection in leukemia children. Conclusion the incidence of nosocomial infection in children with leukemia is high. The common infection sites are respiratory system and digestive system. The common pathogens are Enterobacteriaceae and Staphylococcus. Bone marrow suppression and secondary immune deficiency are the main causes of nosocomial infection in children with leukemia.
【作者单位】：聊城市人民医院儿科一病区;
【基金】：山东省科技厅基金资助项目[JB(S)2014-3-14B-3]
【分类号】：R181.32;R733.7

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