Li Shu-Tan, Tang Liu, Chen Xiao-Min, Li Xiao-Ming
Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Provoince, China.
Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Provoince, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018 Apr;26(2):412-416. doi: 10.7534/j.issn.1009-2137.2018.02.017.
To investigate the influencing factors of nosocomial infection in adult patients with acute myeloid leukemia (AML) and its control strategies.
The clinical data of 109 patients with AML treated in our hospital from June 2014 to June 2017 were retrospectively analyzed. The clinical factors were analyzed retrospectively, and the influencing factors of infection after chemotherapy were explored.
A total of 109 patients received chemotherapy for 267 case-times, the infection occurred in 168 case-times, the nosocomial infection rate was 62.92%, the main affected sites included upper respiratory tract and lung. 155 samples from 168 case-times infection patients were collected and cultured, 32 pathogens were obtained with a positive rate 20.6% (32/155), including 14 Gram-negative bacteria, 9 Gram-positive bacteria and 4 strains of fungi and 5 strains of other pathogens. Statistics showed that the patient's age over 40 years old, hospitalization in spring and summer, glucocorticoid therapy, high intensity chemotherapy, neutrophil count, white blood cell count and hemoglobin content were the independent risk factors for infection after chemotherapy in AML patients (P<0.05).
The age of more than 40 years old, hospitalization in spring and summer, glucocorticoid therapy, high-intensity chemotherapy, white blood cell count, neutrophil count and hemoglobin content are the independent risk factors for infection after chemotherapy in the AML patients with the above-mentioned characteristics, they should be closely monitored, and chemotherapy intensity should be controled, so as to control the occurrence of infection; and in the event of infection, a timely powerful anti-infective treatment would be indispensable.
探讨成人急性髓系白血病（AML）患者医院感染的影响因素及其控制策略。
回顾性分析2014年6月至2017年6月在我院治疗的109例AML患者的临床资料。对临床因素进行回顾性分析，探讨化疗后感染的影响因素。
109例患者共接受化疗267例次，发生感染168例次，医院感染率为62.92%，主要感染部位包括上呼吸道和肺部。采集168例次感染患者的155份样本进行培养，获得32株病原菌，阳性率为20.6%（32/155），其中革兰阴性菌14株，革兰阳性菌9株，真菌4株，其他病原菌5株。统计显示，患者年龄>40岁、春夏季住院、糖皮质激素治疗、高强度化疗、中性粒细胞计数、白细胞计数及血红蛋白含量是AML患者化疗后感染的独立危险因素（P<0.05）。
年龄>40岁、春夏季住院、糖皮质激素治疗、高强度化疗、白细胞计数、中性粒细胞计数及血红蛋白含量是具有上述特征的AML患者化疗后感染的独立危险因素，应密切监测，控制化疗强度，以控制感染的发生；一旦发生感染，及时有效的抗感染治疗必不可少。
