| Objective To investigate the risk factors of nosocomial infection and study thecharacteristics of pathogens, treatment and prognosis in patients with acute leukemia.Methods A total clinical data of778cases of acute leukemia patients were werecollected from acute leukemia in patients from2009January to2010December,analysis the risk factors of nosocomial infection in patients with acuteleukemia,investigate276cases of acute leukemia patients infected place and collect114non-duplicate pathogenic isolates and analysis of their antibiotic resistance ratesand sensitivity rates.Results The prevalence of nosocomial infection was35.54%among778patients，and the prevalence of time-cases was48.84%,The main infection sites were respiratorytract，blood and oral cavity．The incidence of nosocomial infection rates of older group(>60years old) and non elderly group (<60years) were46.47%and32.40%(P <0.01), the incidence of nosocomial infection rates was recorded in14.34%of hospitalstays Less than20days and in77.10%of hospital stays more than20days. Theincidence of nosocomial infection rates of patients with no chemotherapy group, theinduction ease group and strengthen group were18.58%,85.94%and17.34%(P <0.01). The incidence of nosocomial infection rates during severe leucopenia withWBC<0.5×109/L was recorded in72.60%, and with WBC between0.5×109/L and2×109/L were recorded in51.87%,during leucopenia with WBC>2×109/L was recordedin14.11%respectively (P<0.01).The infection rate of patien with non-agranulocytosis group was14.41%,while agranulocytosis duration>7days group andagranulocytosisduration <7days group nosocomial infection rates were37.21%and82.32%(P <0.01).The incidence of nosocomial infection rates of HB<60g/Land HB>60g/Lwere55.16%and27.57%(P <0.01).The incidence of nosocomial infection rates ofalbumin<30g/L and albumin>30g/L were56.52%and32.65%(P <0.01).There will be astatistically significant variables into a condition of the Logistic regression model formultivariate analysis of risk factors, screening out the duration of hospitalization (OR=7.018, P <0.01) and agranulocytosis time (OR=2.950, P <0.01) as the main riskfactors.In276cases of nosocomial infection in patients with a total of128strains ofpathogens detected from, eliminating pollution specimens and repeat isolates, a total of114strains were detected,the detection rate was30%.The main pathogens wereEscherichia coli (21.93%), Klebsiella (15.79%), P.aeruginosa (10.53%), S.aureus(7.02%), S.homonis-homin (6.14%) and S.epidermidis (5.26%). The total prevalenceof EBSLs-Producing strains in E.coli and Klebsiella isolates was72.00%and44.44%,respectively. ESBLs positive strains of high and much more serious resistance rate thanESBLs negative strains (P <0.05), ESBLs-producing strains of E.coli and Klebsiella toimipenem sensitive rate was100%, the resistance to Cefazolin, cefatriaxone,Ceftazidime, Cefotaxime and Cefepime was100%. Separating pseudomonasaeruginosa twelve strains, all were sensitive to imipenem, levofloxacin andciprofloxacin. The sensitivity rate of S.aureus, S. homonis–homin, S.epidermidis toVancomycin and Linezolid was100%,There were12fungi strains(10.53%),all wereCandida, including5Candida glabrata,4candida albicans,3Candida tropicalis, andone case of Candida glabrata was resistance to itraconazole.Conclusion Acute leukemia patients with nosocomial infection was the susceptiblepopulation, time of hospitalization and duration of neutropenia is the independent riskfactor of nosocomial infection. Gram-negative are the main cause of nosoeomial infection in patients with acute leukemia, which to imipenem and Amikacin’s sensitiverate in80%above,linezolid were respectively the highest susceptible for gram-positivebacteriums, so in our treatment, shorten the time of recovery of absolute neutrophilcount and rational use of antibiotics can reduce the prevalence of nosocomial infectionefficiently．... |
