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刚果一家血液肿瘤护理科室的医院获得性感染

Hospital acquired infection in a department of hematology-oncology care in the Congo.

作者信息

Ngolet Lydie Ocini, Bolenga Liboko Alexis Fortuné, Ossibi Ibara Bienvenu Roland, Elira Dokekias Alexis

机构信息

Department of Hematology, Teaching Hospital 13 Auxence Ikonga Avenue, P.O Box 32, Brazzaville, Congo.

Department of Oncology, Teaching Hospital 13 Auxence Ikonga Avenue, P.O Box 32, Brazzaville, Congo.

出版信息

Am J Blood Res. 2021 Apr 15;11(2):191-198. eCollection 2021.

Abstract

OBJECTIVES

Hospital Acquired Infection (HAI) is a major cause of morbidity and mortality in hemato-oncology. The study aims to report the incidence of hospital-acquired infections in patients with hematological malignancies and the risk factors associated with them.

MATERIAL AND METHODS

An observational study with cross-sectional data collection was carried out from January 1, 2019, to April 30, 2020, in the department of hematology of Brazzaville University Hospital. The study concerned 77 patients diagnosed with hematological malignancies admitted for a course of chemotherapy. Written consent was obtained from each participant. Participants were divided into two groups: with HAI (n=50) and without HAI (n=27). They were compared using the chi-square test and Student's T-test. Univariate and multivariate analyses of the association of HAI with all the risk factors were performed for analysis of the 2 x k contingency tables and repeated using logistic regression.

RESULTS

The cumulative incidence was 64.9% with a 95% confidence interval of [53.8-74.7]. The time to onset of HAIs was 10.6±6.50 days. The incidence of HAI was significantly greater in acute myelogenous leukemia (80%), grade 4 neutropenia (80%). The risk factors were hospitalization stay of over 14 days (OR: 1.09), the regimen: daunorubicin-aracytine (OR: 5.96), the hemoglobin level on admission (OR: 0.72), and the neutropenia of grade 4 (OR: 7.9). The most common clinically identified focus of infection was peripheral venous infections. The fatality rate was 10%.

CONCLUSION

The determination of HAI and the identification of its risk factors make it possible to establish prevention strategies.

摘要

目的

医院获得性感染(HAI)是血液肿瘤学中发病和死亡的主要原因。本研究旨在报告血液系统恶性肿瘤患者医院获得性感染的发生率及其相关危险因素。

材料与方法

于2019年1月1日至2020年4月30日在布拉柴维尔大学医院血液科进行了一项采用横断面数据收集的观察性研究。该研究涉及77例被诊断为血液系统恶性肿瘤并接受化疗疗程的患者。获得了每位参与者的书面同意。参与者分为两组:发生HAI的患者(n = 50)和未发生HAI的患者(n = 27)。使用卡方检验和学生t检验对两组进行比较。对HAI与所有危险因素的关联进行单因素和多因素分析,以分析2×k列联表,并使用逻辑回归重复进行分析。

结果

累积发病率为64.9%,95%置信区间为[53.8 - 74.7]。HAI的发病时间为10.6±6.50天。急性髓性白血病患者(80%)和4级中性粒细胞减少患者(80%)的HAI发生率显著更高。危险因素包括住院时间超过14天(OR:1.09)、化疗方案:柔红霉素 - 阿糖胞苷(OR:5.96)、入院时血红蛋白水平(OR:0.72)和4级中性粒细胞减少(OR:7.9)。临床上最常见的感染部位是外周静脉感染。死亡率为10%。

结论

确定HAI及其危险因素有助于制定预防策略。

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