摘要
目的探讨骨髓增生异常综合征(MDS)住院患者发生医院感染的特征及危险因素,为防治该类患者医院感染提供理论依据。方法选取我院血液内科2016年1月—2017年12月收治的226例MDS患者为研究对象,采取回顾性调查的方法分析住院患者中发生医院感染者的特征及其相关危险因素。结果 226例患者住院期间共52例发生医院感染,感染率为23.01%,发生二重感染3例,多重感染2例。其中共培养出病原菌28例,革兰阴性菌15例(53.6%),革兰阳性菌4例(14.3%),真菌9例(32.1%)。单因素分析显示,MDS修订版国际预后评分(IPSS-R)危险分组、住院时间、中性粒细胞数、粒细胞缺乏持续时间、侵袭性操作、白蛋白含量、使用激素、使用地西他滨与MDS住院患者发生医院感染有关(P<0.05);多因素Logistic回归分析显示,IPSS-R预后评分较低、住院时间延长、白蛋白水平下降、粒细胞缺乏持续时间延长以及住院期间使用地西他滨为MDS住院患者发生医院感染的独立危险因素。结论针对MDS住院患者发生医院感染的危险因素,采取针对性的治疗措施,缩短住院时间,可以减少医院感染的发生。
Objective To investigate the characteristics and risk factors of nosocomial infection in patients with myelodysplastic syndrome(MDS),and to provide a theoretical basis for the prevention and treatment of nosocomial infection in such patients.Methods A total of 226 patients with MDS hospitalized in the Department of Hematology in our hospital from January 2016 to December 2017 were selected as subjects in this study.The retrospective investigation was used to analyze the characteristics and related risk factors in hospitalized patients with hospital infection.Results A total of 52 patients were found nosocomial infection during hospitalization,with an infection rate of 23.01%,3 cases with double infections,and 2 cases with multiple infections.Among them,28 cases were found pathogenic bacteria and 15 cases of Gram-negative bacteria(53.6%),4 cases of blue positive bacteria(14.3%)and 9 cases of fungi(32.1%).Univariate analysis showed that MDS revised international prognostic score(IPSS-R)risk grouping,length of hospital stay,neutrophil count,duration of neutropenia,invasive procedure,albumin content,use of hormones and use of decitabine were closely related to nosocomial infection in hospitalized patients with MDS(P<0.05).Multivariate Logistic analysis showed that patients with lower prognostic scores for disease IPSS-R,longer hospital stay,low albumin levels,longer duration of granulocytosis,and use of decitabine during hospitalization were the independent risk factors for nosocomial infection(P<0.05).Conclusion Targeted measures are taken to address the risk of nosocomial infections in hospitalized patients with MDS,which shorten the hospital stay,and can reduce the incidence of nosocomial infection.
作者
张惠桃
肖鸿文
李晓明
ZHANG Hui-tao;XIAO Hong-wen;LI Xiao-ming(Department of Hematology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《天津医药》
CAS
北大核心
2018年第8期832-836,共5页
Tianjin Medical Journal
