Risk Factors Of Nosocomial Infection In Patients With Acute Leukemia During Granulocytopenia After Chemotherapy

Objectives:Explore the relationship between the state of body in patients with acute leukemia in the period of granulocytopenia after chemotherapy and nosocomial infection,and analyze the risk factors of infection.Methods:The clinical data of 159 patients,from September 2016 to September2018,with acute leukemia who underwent chemotherapy and had neutropenia after chemotherapy in the hematology department and geriatric department in the Affiliated Hospital of Hebei University of Engineering were retrospectively collected.According to whether they had infectious diseases during hospitalization,the data were divided into nosocomial infection group(n=108)and non-nosocomial infection group(n=51).SPSS22.0 software was used to analyze the relevant data,t-test or rank-sum test was used to compare the measurement data between groups,and chi-squared test was used to compare the count data between groups,in order to calculat P value.Results : 1.There was a correlation between the type of acute leukemia and nosocomial infection in the period of granulocytopenia after chemotherapy(P<0.05).AML patients were more susceptible to nosocomial infection than ALL patients;2.There was significant difference in age between the two groups(P<0.05),and older age(age?60 years old)could be considered as a risk factor;3.The duration of severe anemia,severe thrombocytopenia and tagranulocytosis,the lowest leucocyte count <0.8×109/L,the lowest hemoglobin concentration and platelet count were closely related to the occurrence of nosocomial infection in the period of granulocytopenia after chemotherapy of acute leukemia(P<0.05);4.There was a correlation between hospitalization days and nosocomial infection in the period of granulocytopenia after chemotherapy of acute leukemia(P<0.05);5.There was a significant difference in the duration of hypoproteinemia between the two groups.It was one of the risk factors for nosocomial infection in the period of granulocytopenia after chemotherapy of acute leukemia(P<0.05);6.Hospitalization in summer and autumn,prophylactic use of antibiotics and non-use of recombinant human granulocyte colony-stimulating factor before infection were associated with nosocomial infection in the period of granulocytopenia after chemotherapy of acute leukemia(P<0.05);7.There was no significant difference between the sexes of the two groups(P>0.05);8.Fasting blood sugar,ferritin,immunoglobulin(Ig G,Ig A,Ig M),lactate dehydrogenase(LDH),non-use of thrombopoietin(TPO)before infection and so on are not the risk factors for nosocomial infection in the period of granulocytopenia after chemotherapy of acute leukemia.Conclusions:1.The incidence of nosocomial infectious diseases in patients with acute leukemia after chemotherapy is particularly high(67.92%).Preventing and controlling nosocomial infections plays a positive role in improving the treatment level and prognosis of leukemia;2.For patients with acute leukemia after chemotherapy,especially the elderly AML patients who are houspitalized in sunmmer and atumn,we should pay close attention to the relevant laboratory indicators,actively give various supportive treatment,correct hypoproteinemia as soon as possible,infuse constituent blood when necessary,inject recombinant human granulocyte colony stimulating factor reasonably and use prophylactic antibiotics,and minimize the number of hospitalization days of patients,in order to reduce the incidence of nosocomial infections in the period of granulocytopenia after chemotherapy of acute leukemia.