Retrospective Analysis Of Adult Acute Leukemia Complicated With Nosocomial Infection

Objective:To explore situation and related risk factors of acute leukemia patients with nosocomial infection.Method:Select the First Affiliated Hospital of Shihezi University School of Medicine,Department of Hematology,from January2010to December2011diagnosis of acute leukemia in patients hospitalized cases wereinvestigated.By using the method of retrospective survey cases and accessing to formulate a unifiedquestionnaire,the clinical data of patients with adult acute leukemia were classified and summarized.Usingthe SPSS17.0statistical software analytical data,carries on the significance variable that the single factoranalysis screens the non-condition Logistic regression analysis.Results:1. Adult acute leukemia combined incidence of nosocomial infection was49.2%and14patients had multi-site infection.Respiratory tract infection is the most common site of nosocomial infection (60%),followedby urinary and blood.2. Mainly Gram-negative bacteria cause infection pathogens (62.5%),followed by Gram-positive bacteria(25.0%),fungi (12.5%).Gram-negative bacteria to imipenem/cilastatin,piperacillin/tazobactam and amikacinsensitive.Gram positive bacteria were sensitive to vancomycin and levofloxacin.3. Single factor shows:age,hospitalization time,whether or not associated with other diseases,peripheralwhite blood cell count,hemoglobin,albumin,agranulocytosis time and chemotherapy stage had significantdifference.Patients over60age incidence of nosocomial infection was64.9%,higher than patients youngerthan60years of age.The female and male patients with nosocomial infection rate of49.3%and49.1%,thedifference was not statistically significant.With the prolongation of hospital stay,hospital infection ratesincreased significantly.All the year round,winter spring rates higher than the fall, no statistical difference.The incidence of nosocomial infection in acute lymphoblastic leukemia (58.8%) was higher than that ofacute nonlymphocytic leukemia (47%).With other diseases (diabetes,chronic obstructive pulmonary disease,etc.) of the hospital infection rate is high in patients with acute leukemia.White blood cell count is less than1.0×10~9/L,the incidence of nosocomial infection was96.1%.Hemoglobin and albumin content decrease,thehospital infection rate increased accordingly.When granulocyte lack time more than7days,all patients withnosocomial infection occurred.Chemotherapy without to its sugary corticosteroids hospital infectionincidence (47.1%) was lower than the containing hormones persons (60.0%).Initial induction therapy orrelapse again after induction therapy in patients with nosocomial infection incidence (67.6%) wassignificantly higher than consolidating treatment of patients (20.8%).4. The results of multivariate analysis showed that age,duration of hospitalization,peripheral white bloodcell counts and chemotherapy stage were independent risk factors of hospital infection.Conclusion:1. The incidence of nosocomial infection in patients with adult acute leukemia is high.The main infection site was respiratory tract, urinary tract,blood,oral cavity,etc.The site of infection is unknown in nosocomialinfection in acute leukemia accounted for a considerable proportion.The course of chemotherapy shouldpay special attention to the observation,in order to early discovery and early treatment.2. Gram-negative bacteria are the main pathogens of adult acute leukemia patients with nosocomialinfection.Most pathogens are conditional pathogenic bacteria.Most of the acute leukemia combined hospitalinfection are endogenous infection.3. Age,hospitalization time,peripheral white blood cell count and chemotherapy stage are independent riskfactors of adult acute leukemia patients with hospital infection.Take positive and effective measures willhelp to prevent and control hospital infection in adult acute leukemia patients.