摘要
目的分析急性髓系白血病(AML)诱导缓解期患者下呼吸道感染的病原菌分布及相关因素,为医院感染预防和控制工作提供客观依据。方法选取2015年1月-2016年12月医院收治的AML诱导缓解期患者60例为研究对象,回顾性分析患者的下呼吸道感染发生率,对感染患者分泌物标本中的病原菌分布进行检测和分析,对与AML诱导缓解期患者发生下呼吸道感染的相关因素进行回顾性研究和分析。结果 49例于诱导缓解期发生下呼吸道感染,感染率为81.7%;共检出17株病原菌,以革兰阴性菌为主,共11株占64.7%;肺部影像学特点主要以双肺病变为主,占59.2%;logistic多元回归分析结果显示,化疗方案(IA)、血红蛋白(≤60g/L)、白蛋白(≤30g/L)是发生AML诱导缓解期患者下呼吸道感染的独立危险因素(P<0.05)。结论 AML诱导缓解期患者下呼吸道感染的病原菌分布、相关因素和临床影像学特点均具有一定的特征性,临床医师应给予高度的重视和有效的干预,以提高医院感染控制效果、确保化疗疗效、改善患者的预后。
OBJECTIVE To analyze the distribution of pathogenic bacteria and related factors in patients with acute myeloid leukemia （AML） complicated with lower respiratory tract infections at induced remission stage, so as to provide basis for the prevention and control of nosocomial infections.METHODS A total of 60 patients with AML at induced remission stage from Jan.2015 to Dec.2016 were selected as the research subjects.The incidence of lower respiratory tract infections of all the included patients was retrospectively analyzed.The distribution of pathogenic bacteria in samples of lower respiratory tract secretion of patients with lower respiratory tract infection secretion samples were detected and analyzed.The related factors of occurrence of lower respiratory tract infections in patients with AML at induced remission stage were retrospectively investigated and analyzed.RESULTS There were 49 cases with lower respiratory tract infections at induced remission stage, with the infection rate of 81.7%.Totally 17 strains of pathogenic bacteria were detected, which were mainly 11 strains of gram-negative bacteria, accounting for 64.7%.The main characteristics of patients with lower respiratory tract infection were lesions in both sides, accounting for 59.2%.Logistic multivariate regression analysis showed that chemotherapy scheme （IA）, hemoglobin level （≤60 g/L） and albumin （≤30 g/L） were independent risk factors for lower respiratory tract infection in patients with AML at induced remission stage （P〈0.05）.CONCLUSION The distribution of pathogenic bacteria, related factors, and clinical imaging characteristics of patients with AML complicated with lower respiratory tract infections at induced remission stage have certain features.The clinicians should pay more attention and effective interventions to improve the effect of nosocomial infections, ensure the therapeutic effects of chemotherapy, and improve the prognosis of the patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第16期3647-3650,共4页
Chinese Journal of Nosocomiology
基金
甘肃省科技厅基金资助项目(1205TCYA023)
关键词
急性髓系白血病
诱导缓解期
下呼吸道感染
病原菌分布
相关因素
Acute myeloid leukemia
Induced remission stage
Lower respiratory tract infection
Pathogenic bacteria distribution
Related factors
