Clinical Analysis Of Acute Leukemia Complicated With Nosocomial

Objective: To investigate the incidence of acute leukemia complicated with sepsis and characteristics of etiology, to study its clinical characteristics, and to provide valuable reference for the prevention and treatment.Materials and methods: Retrospective methods was used to analyzed the clinical data of acute leukemia complicated with sepsis, which treated in 2009 October to 2014 October of The First Hospital of Quanzhou, pathogenic microorganism and susceptible factors of infectious complications were analyzed by Chi square test and Fisher exact probability method.Results: 1.The primary site of infection in sepsis:Respiratory infection was 23 cases times in all(54.7%), oral infection was 3 cases times(7.14%), the intestinal infection was 3 cases times(7.14%), and the infection unknown was 9 cases times(21.4%).2. Analysis of pathogens and drug sensitivity results: In the positive blood culture results, Gram-negative bacteria have the highest infection rate, total 31 cases, account 73.8%. Escherichia coli was the most, total 14 cases, accounting for 33.3%. Gram-positive bacteria(11 cases times) accounted for 21.2%, staphylococcus aureus(3 cases times, 7.1%), enterococcus faecium(3 cases times, 7.1%). The 4 cases ESBLs were Escherichia coli, account 12.9%. The Gram-negative bacterium to carbapenem antibiotic resistance rate is low, Gram-positive bacteria to vancomycin, teicoplanin, linezolid resistance rate of the minimum. 3. Analysis of the risk factors associated with septicemia infection: Gender, age, invasive operation on acute leukemia complicated with sepsis rate had no effect. Sepsis happened in autumn and summer are more than in spring and winter. MAL has a higher incidence rate than ALL and AML. The numbers of days of hospitalization, disease state, glucocorticoid, neutrophil count are important factors affecting the incidence of sepsis.Conclusion: 1.The common primary infection site of acute leukemia complicated with sepsis was respiratory, intestinal and oral. The most commonly identifiedorganisms was gram-negative bacteria, gram-negative bacteria primarily of antibiotics should be the first selection of empirical anti-infection treatment. 2. The resistant rates of bacteria increased year by year. We should be careful to choose reasonable antibiotics drugs, to avoid the empirical application of the three generation cephalosporin and reduce the production of extended-spectrum β-lactamases resistant infection. 3. The season, days of hospitalization, disease type, disease state, glucocorticoid application, and neutrophils are the factors for nosocomial sepsis. We can reduce the incidence of nosocomial sepsis in patients with acute leukemia through identifying these high risk factors and taking targeted measures of prevention.