成人急性白血病患者住院化疗感染的临床特征及影响因素研究

OBJECTIVE: To observe the clinical characteristics of infections in adult acute leukemia (AL) patients during chemotherapy in hospital, and identify the risk factors for infections. METHODS: A retrospective study of patients with AL who underwent chemotherapy between July 2010 and Dec 2014 in the First Affiliated Hospital of Xiamen University was conducted. Clinical features and risk factors for infections were analyzed. RESULTS: 191 patients with AL received a total of 728 courses of chemotherapies. During these admissions, 385 (52.9%) infections episodes occurred. The common infections sites were lower respiratory tract infection (36.3%, 153/374), bloodstream infection (17.1%, 64/374), oral infection (13.6%, 51/374), and perianal infection (13.4%, 50/374). 164 strains of pathogenic bacteria were detected. Gram-negative bacteria were recorded in 59.1% of documented pathogens, and Gram-positive bacteria were responsible for 32.9% of infections. Multivariate unconditioned logistic analysis of factors identified consistent independent risk factors for no completely remission (OR=0.142, P< 0.001), duration of neutropenia longer than 7 days (OR=12.764, P<0.001), general wards (OR=1.821, P< 0.001), and hospitalization interval longer than 10 days (OR=0.720, P=0.039). CONCLUSION: Infections after chemotherapy for AL continues to be common. AL patients with induction chemotherapy or severe neutropenia faced an increased risk of infections by multivariate analysis. And patients with short-term stay or laminar flow wards seem to be less susceptible to infections.