Objective To investigate the incidence of central line-associated bloodstream infection (CLABSI) in patients with hematopoietic stem cell transplantation (HSCT), explore risk factors for the occurrence of CLABSI.Methods Basic information of patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) who underwent HSCT in a hematology department from November 1, 2016 to October 31, 2017 was collected, incidences of original CLABSI (OCLABSI) and modified CLABSI (MCLABSI) were calculated, related risk factors were analyzed by multivariate Cox regression.Results A total of 218 patients with AML and MDS who underwent HSCT were enrolled, 19 of whom had OCLABSI and 10 had MCLABSI.Twenty-one strains of pathogens were isolated from 19 patients with OCLABSI, including 9 gram-positive bacteria, 11 gram-negative bacteria, 1 fungus;9 strains were multidrug-resistant organisms.The main risk factors for OCLABSI included the female (HR=0.088;95％CI:0.017-0.440;P=0.003), age (HR=1.560;95％CI:1.066-2.530;P=0.034), bone marrow cell transplantation only (HR=4.408;95％CI:1.860-22.593;P=0.043), ATG/CSA/MMF/MTXG for preventing graft-versus-host disease (GVHD) (HR=0.101;95％CI:0.015-0.686;P=0.019), and MTX for preventing GVHD (HR=0.097;95％CI:0.011-0.816;P=0.032).Conclusion Definition of MCLABSI can provide more accurate monitoring on deep central venous catheter-related bloodstream infection.Incidence of CLABSI in HSCT patients can be reduced by early detection of high-risk population according to high-risk factors, strict adherence to the prevention and control measures of bloodstream infection, and implementation of immune recombination after enhanced transplantation.%目的 研究中心静脉导管相关血流感染(CLABSI)在造血干细胞移植(HSCT)患者中的发病情况,探讨影响其发生的危险因素.方法 收集2016年11月1日—2017年10月31日于血液科行HSCT的急性髓系白血病(AML)和骨髓增生异常综合征(MDS)患者的基本信息,计算传统CLABSI(OCLABSI)和校正CLABSI(MCLABSI)发病率,使用多因素Cox回归对相关危险因素进行统计学分析.结果 共纳入218例行HSCT的AML和MDS患者,其中19例OCLABSI,10例患者发生MCLABSI.19例OCLABSI患者中共分离病原菌21株,其中革兰阳性菌9株,革兰阴性菌11株,真菌1株;多重耐药菌9株.OCLABSI的影响因素包括女性(HR=0.088;95％CI:0.017～0.440;P=0.003),年龄(HR=1.560;95％CI:1.066～2.530;P=0.034),只移植骨髓细胞(HR=4.408;95％CI:1.860～22.593;P=0.043),使用ATG/CSA/MMF/MTX预防GVHD(HR=0.101;95％CI:0.015～0.686;P=0.019),使用MTX预防GVHD(HR=0.097;95％CI:0.011～0.816;P=0.032).结论对MCLABSI的定义可以更加精确的监测深静脉导管引起的血流感染.根据高危因素早期发现高风险人群,严格遵守血流感染的预防控制措施,实施增强移植后患者免疫重组的方案,可减少HSCT患者CLABSI发病率.
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