摘要
目的分析慢性淋巴细胞白血病(CLL)患者医院感染的病原菌分布及危险因素。方法回顾性分析2010年1月至2015年12月CLL患者64例的临床资料,观察CLL患者医院感染发生率、感染部位、病原菌的构成及病原菌耐药情况。对发生医院感染的相关因素行单因素检验和多因素的非条件logistic回归分析。结果 64例CLL患者中发生院内感染26例,感染发生率为40.6%。26例院内感染患者中,呼吸道感染发生率最高为14例(21.8%),共检测出病原菌株7株,革兰阴性杆菌株4株,分别为肺炎克雷伯菌2株,大肠埃希菌2株;革兰阳性球菌株2株,为金黄色、表皮葡萄球菌各1株;真菌菌株为1株,为光滑假丝酵母菌。单因素分析显示,CLL患者院内感染与患者化疗方案、疾病分期、粒细胞缺乏持续时间(粒缺时间)、血红蛋白水平、白蛋白水平、CD4^+T淋巴细胞有关(P<0.05,P<0.01)。多因素logistic回归分析显示,CD4^+T淋巴细胞≤0.5×109/L、血红蛋白≤100 g/L、含氟达拉滨的化疗方案为CLL患者院内感染的危险因素(P<0.05,P<0.01)。结论根据CLL患者医院感染的特点,CLL发生院内感染时,可对其危险因素进行干预,感染发生后,应选用敏感抗菌药物进行治疗。
Objective To analyze pathogen distribution and risk factors of nosocomial infection in patients with chronic lymphocytic leukemia（CLL）. Methods Retrospective analysis on clinical data of 64 patients with CLL from January 2010 to December 2015 was performed. Incidence of nosocomial infection, sites of infection and composition of pathogens and drug resistance of pathogens were observed. Single factor analysis and multivariate unconditional logistic regression analysis were performed to analyze the relevant factors of nosocomial infection. Results Among 64 CLL patients, nosocomial infec- tion occurred in 26 cases, so the incidence of nosocomial infection was 40.6%. Among 26 patients with nosocomial infec- tion,the incidence of respiratory tract infection was the highest （ 14/26,21.8% ）. A total of 7 strains of pathogens were de- tected including 4 strains of Gram-negative bacilli （ 2 strains of Klebsiella pneumoniae bacilli ,2 strains of Escherichia co- li） , 2 strains of Gram-positive cocci （ 1 strain of Staphylococcus aureus, 1 strain of Staphylococcus epidermidis ） and 1 strain of fungus （ candida glabrata）. Single factor analysis showed that chemotherapy regimen, staging of disease, granulo- cyte deficiency duration, hemoglobin level, albumin level and CD4 ＋ T lymphocyte level were associated with nosocomial in- fection of CLL patients. Multivariate logistic regression analysis showed that CD4 ＋ T lymphocyte level less than or equal to 0.5 ×10^9/L,hemoglobin level less than or equal to 100 g/L and chemotherapy regimen containing fludarabine were the risk factors of nosocomial infection of CLL patients. Conclusion When nosocomial infection occurs in CLL patients, the risk factors can be intervened according to the characteristics of nosocomial infection in CLL patients, and sensitive antibacteri- als should be chosen for the treatment of CLL.
作者
王增胜
聂玉玲
毛敏
陶玲
张晓燕
李燕
王晓敏
WANG Zeng-sheng NIE Yu-ling MAO Min TAO Ling ZHANG Xiao-yan LI Yan WANG Xiao-min(Department of Hematology, Xinjiang Uygur Autonomous Region People＇s Hospital, Urumqi, Xinjiang Uygur Autonomous Region 830000, Chin)
出处
《中国临床研究》
CAS
2017年第3期302-305,共4页
Chinese Journal of Clinical Research
基金
国家自然科学基金(81460033)
关键词
慢性淋巴细胞白血病
医院感染
危险因素
感染发生率
感染部位
病原菌
Chronic lymphocytic leukemia
Nosocomial infection
Risk factors
Incidence of infection
Site of infec-tion
Pathogen
作者简介
通讯作者：毛敏，E-mail：15214804974@139．com
