Characteristics And Risk Factors Of Infection After Chemotherapy In Elderly Patients With Acute Myeloid Leukemia

Objectives:To explore the characteristics of nosocomial infection in elderly patients with acute myeloid leukemia after chemotherapy,and to analyze the related risk factors of nosocomial infection after chemotherapy,so as to provide an objective basis for clinical prevention and treatment of nosocomial infection in elderly patients with acute myeloid leukemia after chemotherapy.Methods:A total of 32 patients(excluding acute promyelocytic leukemia(M3)patients aged 60 years or older who were admitted to the hematology department of the second affiliated hospital of kunming medical university from December 2014 to December 2018 and who met the inclusion and exclusion criteria were selected.A total of 106 cases of chemotherapy were completed.Retrospective investigation method was used to review the cases and fill in the unified questionnaire.The case data of elderly acute myeloid leukemia were summarized and summarized.SPSS22.0 statistical software was used for single-factor log-rank test and multifactor COX regression analysisResults:1.Among the 32 elderly patients with acute myeloid leukemia(M3 excluded),82 patients had nosocomial infection after 106 rounds of chemotherapy,with an infection rate of 77.4%(82/106).Patients often suffered from multiple or multiple site infections.The number of cases was 109 times according to the location of nosocomial infection,and the incidence of nosocomial infections was 102.8%(109/106)2.Lung infection(36.7%)was the most common site of nosocomial infection in elderly patients with acute myeloid leukemia(M3 excluded)after chemotherapy,followed by upper respiratory tract infection(22.9%),blood flow infection(13.8%),oral infection(10.1%)and perianal infection(9.2%).In the data of 82 nosocomial infections,there were 23 cases with two or more nosocomial infections,accounting for 28.1%.3.Geriatric patients with acute myeloid leukemia(M3 excluded)were mainly infected by gram-negative bacteria(42.9%)after chemotherapy,and klebsiella pneumoniae and escherichia coli were the main pathogens.Secondly,gram-positive bacteria(32.1%),mainly staphylococcus epidermidis and methicillin-resistant staphylococcus aureus.The fungi(14.3%)were mainly candida albicans.Viral infection(10.7%)was predominantly cutaneous herpes(EB)4.Univariate analysis showed that there were 7 statistically significant variables,age,basic disease,disease stage,bone marrow primitive cell ratio,albumin value,days of granulocyte deficiency,and CCI score were risk factors for nosocomial infection in elderly AML patients after chemotherapy(P<0.05).When age 70 years old,the presence of basic diseases,the stage of induced remission,the proportion of bone marrow primitive cells 50%.the albumin value<35g/L,the number of time of granulocyte deficiency 7,and the CCI score 2,the fever time of elderly patients with hospital-acquired acute myeloid leukemia after chemotherapy significantly increased,and these 7 variables were associated with hospital-acquired infection.5.Multivariate COX regression analysis showed that the proportion of bone marrow primitive cells,albumin and granulocyte deficiency time were independent risk factors for nosocomial infection in elderly AML patients after chemotherapy.Conclusions:1.The infection rate of nosocomial infection in elderly patients with acute myeloid leukemia(M3 excepted)after chemotherapy was relatively high.The main infection site was lung,followed by upper respiratory tract infection,and then blood flow,oral cavity and perianal infection.2.Geriatric patients with acute myeloid leukemia(M3 excluded)were mainly caused by gram-negative bacteria,followed by gram-positive bacteria,and then by fungal and viral infections.3.Univariate analysis showed that 7 variables related to nosocomial infection after chemotherapy:age,based disease,induction remission stage,bone marrow primordial cell proportion,albumin value,granulocyte deficiency time and CCI score.Multivariate COX regression analysis showed that the proportion of bone marrow primitive cells,albumin and granulocyte deficiency time were independent risk factors for nosocomial infection in elderly patients with acute myeloid leukemia after chemotherapy.Active and effective measures should be taken to reduce the incidence of nosocomial infection in elderly patients with acute myeloid leukemia after chemotherapy.