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目的探讨急性白血病(acute leukemia,AL)并多重耐药大肠埃希菌(multidrug resistant Escherichia coli,MDRE.coli)血流感染患者死亡相关危险因素。方法 AL并MDR-E.coli血流感染患者106例,根据药物敏感试验结果应用敏感抗生素治疗2周,记录治疗30d内生存情况,将106例患者分为死亡组24例和生存组82例,采用多因素logistic回归分析患者30d内死亡的危险因素。结果死亡组年龄>45岁比率(45.83%)、治疗期间发生感染性休克比率(62.50%)、治疗前30d应用糖皮质激素比率(45.83%)高于生存组(23.17%、3.66%、24.39%)(P<0.05);多因素logistic回归分析结果显示,治疗期间发生感染性休克(OR=47.33,95%CI:10.14~220.83,P=0.000)和治疗前30d应用糖皮质激素治疗(OR=4.13,95%CI:1.05~16.20,P=0.042)是AL并MDR-E.coli血流感染患者治疗30d内死亡的危险因素。结论治疗期间发生感染性休克、治疗前30d应用糖皮质激素与AL并MDR-E.coli血流感染患者治疗30d内死亡有关。
Objective To investigate the risk factors associated with mortality in patients with acute leukemia (AL) and multi-drug resistant Escherichia coli (MDRE.coli) infection. Methods 106 patients with AL and MDR-E.coli bloodstream infection were treated with sensitive antibiotics for 2 weeks according to the result of drug sensitivity test. The survival of the patients was recorded within 30 days after treatment. 106 patients were divided into 24 death patients and 82 survival patients. Multivariate logistic regression analysis was used to analyze the risk factors of death within 30 days. Results The rate of septic shock (62.50%) in the death group was 45 years old (45.83%). The glucocorticoid ratio (45.83%) in the death group was significantly higher than that in the survival group (23.17%, 3.66%, 24.39% (OR = 47.33, 95% CI: 10.14 ~ 220.83, P = 0.000), and 30 days before treatment with glucocorticoid (OR = 4.13, 95% CI: 1.05-16.20, P = 0.042) were risk factors for death within 30 days after AL and MDR-E.coli infection. Conclusions Septic shock occurred during the treatment. Glucocorticoid 30 days before treatment was associated with death within 30 days after treatment with AL and MDR-E.coli bloodstream infection.