Single Center Analysis Of Nosocomial Infection In Children With Malignant Tumor During Myelosuppression After Chemotherapy

Objective To study and analyze the occurrence,type or site,etiological characteristics and related risk factors of nosocomial infection in children with malignant tumor during myelosuppression after chemotherapy,so as to provide basis for clinical prevention and treatment of infection in children with malignant tumor in the future.Methods The general data,infection,pathogens and risk factors of nosocomial infection in children with malignant tumor diagnosed in the pediatric ward of General Hospital of Ningxia Medical University from 2019.01 to 2022.01 were analyzed retrospectively.Results1.There were 169 cases of nosocomial infection in 82 children with malignant tumor during myelosuppression,among which hematological malignancies accounted for the highest proportion;2.Respiratory tract infection accounted for the highest proportion,accounting for39.05% of the total infection site,followed by infectious fever(location unknown),accounting for 29.59%;3.The risk factors of infection during myelosuppression were: hospital stay,the lowest white blood cell count level,neutrophil count level,duration of agranulocytosis;independent risk factors were: hospital stay,the lowestneutrophil count level and duration of agranulocytosis;4.The positive rate of nosocomial infection pathogens in myelosuppression was 10.9%,mainly Gram-negative bacteria,followed by Gram-positive bacteria.In addition,6 strains of fungi and 6 viruses were detected;5.The results of drug sensitivity test of some Gram-positive bacteria showed that all of them were sensitive to vancomycin and linezolid.Staphylococcus aureus was also sensitive to levofloxacin,oxacillin and tetracycline and resistant to sulfamethoxazole.Streptococcus pneumoniae and Enterococcus faecium were resistant to erythromycin and tetracycline.Escherichia coli was completely resistant to sulfamethoxazole,minocycline and doxycycline(100%),and highly sensitive to amikacin,cefotetan,imipenem and piperacillin / tazobactam.Carbapenem-resistant Escherichia coli was resistant to most antibiotics and was sensitive only to nitrofurantoin,tegacycline,ampicillin,amikacin and aztreonam.Pseudomonas aeruginosa was sensitive to the tested drugs and there were no drug-resistant antibiotics.Candida albicans were sensitive to 5-fluorouracil,fluconazole,itraconazole and voriconazole.Conclusions1.In the stage of myelosuppression after chemotherapy,the nosocomial infection of pediatric malignant tumor was the highest in hematological system,and the infection site was mainly respiratory tract infection,and there were multiple site infections.2.Hospital stay,the lowest neutrophil count level and duration of agranulocytosis in myelosuppressive stage were closely related to nosocomial infection.3.The positive rate of pathogen detection of nosocomial infection in myelosuppression stage was low,and gram-negative bacteria were dominant inour hospital,followed by Gram-positive bacteria.