中国感染控制杂志2019，Vol.18Issue(2)：127-131,5.DOI:10.12138/j.issn.1671-9638.20193808
造血干细胞移植患者发生中心静脉导管相关血流感染的多因素研究
Multivariate study on central line-associated bloodstream infection in patients undergoing hematopoietic stem cell transplantation
韩如慧 1金美娟 1钱雪峰 1乔美珍 1陈凯 1吴琛2
作者信息
- 1. 苏州大学附属第一医院感染管理处, 江苏 苏州 215006
- 2. 苏州大学附属第一医院肿瘤科, 江苏 苏州 215006
- 折叠
摘要
Abstract
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.关键词
中心静脉导管相关血流感染/造血干细胞移植/CLABSI/HSCTKey words
central line-associated bloodstream infection/hematopoietic stem cell transplantation/CLABSI/HSCT分类
医药卫生引用本文复制引用
韩如慧,金美娟,钱雪峰,乔美珍,陈凯,吴琛..造血干细胞移植患者发生中心静脉导管相关血流感染的多因素研究[J].中国感染控制杂志,2019,18(2):127-131,5.
