论文部分内容阅读
目的探讨恶性淋巴瘤患者发生医院感染病原菌构成情况及感染因素分析。方法选取医院2014年1月-2016年9月接诊的恶性淋巴瘤患者178例,将恶性淋巴瘤伴医院感染的52例患者为感染组,其余126例为未感染组,对感染者进行病原菌和药敏分析,分析感染的主要病原菌构成,并做出相应的抗菌药物耐药性分析,对其感染相关因素进行单因素及多因素分析。结果恶性淋巴瘤医院感染52例,感染率29.21%,主要感染部位为呼吸道和口腔;共检测出84株病原菌,其中革兰阴性菌47株占55.95%,以肺炎克雷伯菌、铜绿假单胞菌及大肠埃希菌为主;革兰阳性菌22株占26.19%,真菌15株占17.86%。肺炎克雷伯菌对氨苄西林耐药性最强93.75%,对头孢他啶耐药性最弱37.50%,铜绿假单胞菌对氨苄西林耐药性最强91.67%,对头孢呋辛的耐药性最弱33.33%,大肠埃希菌对头孢哌酮耐药性最强90.91%,对头孢西丁耐药性最弱36.36%。多因素结果显示,侵入性治疗、住院天数、合并其他疾病、抗菌药物和年龄是恶性淋巴瘤伴医院感染的独立影响因素(P<0.05)。结论恶性淋巴瘤医院感染主要感染部位为呼吸道及口腔,感染病原菌以革兰阴性菌为主,临床应结合感染的独立因素加强防范,根据患者病情、耐药性合理用药。
Objective To investigate the constitution and infection of nosocomial pathogens in patients with malignant lymphoma. Methods A total of 178 patients with malignant lymphoma admitted to the hospital from January 2014 to September 2016 were enrolled. 52 patients with malignant lymphoma and nosocomial infection were infected, and the remaining 126 patients were uninfected. The pathogenic bacteria And drug susceptibility analysis, analysis of the composition of the main pathogens of infection, and make the corresponding antimicrobial drug resistance analysis of factors related to its infection by univariate and multivariate analysis. Results There were 52 cases of nosocomial infection of malignant lymphoma with infection rate of 29.21%. The main infection sites were respiratory tract and oral cavity. A total of 84 pathogens were detected, of which 47 strains were gram-negative bacteria accounting for 55.95%. Klebsiella pneumoniae, Escherichia coli and Escherichia coli; Gram-positive bacteria accounted for 26.19% of 22 strains, fungi 15 strains accounted for 17.86%. Klebsiella pneumoniae was the most resistant to ampicillin 93.75%, the weakest 37.50% against ceftazidime, the strongest resistant to ampicillin 91.67%, the resistance to cefuroxime The weakest 33.33%, Escherichia coli most resistant to cefoperazone 90.91%, the weaker resistance to cefoxitin 36.36%. Multivariate analysis showed that invasive treatment, length of hospital stay, combined with other diseases, antimicrobial agents and age were independent influencing factors of nosocomial infection of malignant lymphoma (P <0.05). Conclusions The main infection sites of nosocomial infection of malignant lymphoma are respiratory tract and oral cavity. Gram-negative bacteria are the main pathogens causing infection in malignant lymphoma. Clinical prevention should be strengthened with independent factors of infection. According to the patient’s condition, drug resistance should be rationally used.