目的 探讨儿童急性淋巴细胞白血病(ALL)初始诱导化疗后院内感染的临床特点,指导相应的防治对策.方法 选取60例初治的ALL完成初始诱导化疗后的临床资料进行回顾性分析,对感染率、感染部位、病原菌、感染持续时间,以及危险因素等进行分析.结果 在纳入分析的60例患儿中,35例患儿发生感染,感染64例次,感染率58.33%,感染部位以呼吸道最多占82.82%,感染持续时间平均16.98 d,培养阳性率28.54%,其中血培养阳性率最高,致病菌以革兰阴性杆菌最多占60.00%,年龄、中性粒细胞绝对值及是否住层流床与感染有关.结论 初治ALL患儿在初始诱导化疗中极易发生感染,感染好发部位是呼吸道,病原菌培养率低,且以革兰阴性杆菌多见,低龄儿童、中性粒细胞绝对值、是否使用层流床都是院内感染发生的危险因素.%Objective To investigate the causes and prevent measures of nosocomial infection in children with newly diagnosed acute lymphoblastic leukemia (ALL) during initial treatment.Methods A retrospective study of 60 newly diagnosed acute leukemia lymphoblastic leukemia children after initial treatment was performed.The nosocomial infection rate,the infection sites,etiology monitoring,infection times and risks of infection were analyzed.Results Among 60 ALL children,nosocomial infections occurred in 35 cases,while the episodes were 64 cases,the infection rate was 58.33%;the respiratory system was the most common site of tract infection,rate was 82.82%;the average of infection times were 16.98 days;the positive rate of pathogens culture was 28.54%,the most positive rate was blood culture,the positive of blood culture was 60%.Among all the pathogens,gram-negative bacteria accounted 60.00%,taking the top shot of all bacteria;the risks of nosocomial infection were ages,numbers of neutrophil and whether living in laminar flow beds.Conclusion There is high incidence of nosocomial infection during the children with acute leukemia who are newly diagnosed.The most regular infected site is respiratory tract.The incidence of gram-negative bacteria is highest.The risks of nosocomial infection are the ages of children,numbers of neutrophil and whether using of laminar flow beds.
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