Crane L R, Emmer D R, Grguras A
Nurs Clin North Am. 1980 Dec;15(4):843-55.
Various combinations of immune deficiency, tumor effect, surgery, ionizing radiation, chemotherapy, and neutropenia result in infection-prone states for hospitalized cancer patients. Recognition of nosocomial infection may be difficult, and fever may be the only finding. Pathogens may be exogenously acquired from the contaminated hospital environment. Transmission by contact with hospital personnel is the usual mode of exogenous acquisition of hospital bacteria, and handwashing is the most effective means of prevention. The utility of conventional protective isolation in prevention of exogenous transmission is in question. Inattention to infection control measures by nurses and physicians may result in higher infection rates and more serious types of infections. Endogenous infection by the patient's own bacteria and fungi also occurs in the cancer ward. Autoinfection is "amplified" by the use of cannulae, catheters, and other hospital devices. Meticulous nursing care, particularly in neutropenic persons, is important in reducing the incidence of endogenous spread of microbes. Exogenous and endogenous infections in neutropenic patients are reduced using laminar air flow rooms combined with prophylactic antibiotics. It is still not clear if these expensive measures are effective in prolonging survival of patients with acute leukemia.
免疫缺陷、肿瘤影响、手术、电离辐射、化疗和中性粒细胞减少的各种组合，导致住院癌症患者处于易于感染的状态。医院感染的识别可能很困难，发热可能是唯一的表现。病原体可能从受污染的医院环境中外源性获得。通过与医院工作人员接触传播是医院细菌外源性获得的常见方式，洗手是最有效的预防手段。传统的保护性隔离在预防外源性传播方面的效用存在疑问。护士和医生对感染控制措施的疏忽可能导致更高的感染率和更严重的感染类型。患者自身的细菌和真菌引起的内源性感染也发生在癌症病房。使用套管、导管和其他医院设备会“加剧”自身感染。精心的护理，尤其是对中性粒细胞减少的患者，对于降低微生物内源性传播的发生率很重要。使用层流空气病房并联合预防性抗生素可减少中性粒细胞减少患者的外源性和内源性感染。目前尚不清楚这些昂贵的措施是否能有效延长急性白血病患者的生存期。
