通讯作者: 李睿, lirui@ihcams.ac.cn

DOI：10.12201/bmr.202604.00126

Clinical characteristics and risk factors of nosocomial infection in children with hematological diseases

• 摘要：摘要 目的 探讨儿童血液病住院患儿医院感染（nosocomial infection，NI）的临床特征、病原学分布及危险因素，为精准制定感染防控策略提供依据。方法 选取2024年1月-2024年12月中国医学科学院血液病医院收治的3256例血液病住院患儿作为研究对象，分析其NI患儿的临床资料、感染部位分布、病原学特征等数据，采用单因素分析和多因素Logistic回归分析筛选NI独立危险因素。结果 共发生感染313例，感染发生率9.61%；累计感染326例次，感染例次率10.01%。感染部位分布以血流感染和呼吸道感染为主，分别为113例次（34.66%）、111例次（34.05%）。获取致病病原体180株，包括革兰阳性菌88株（48.89%），革兰阴性菌68株（37.78%），病毒16株（8.89%）、真菌8株（4.44%）。多因素分析显示，住院时间＞10天、发热时间＞2天、联合使用抗菌药物及最低中性粒细胞计数＜0.5×109 /L是患儿NI的独立危险因素（P＜0.05）。结论 血液病住院患儿医院感染发生率高，革兰阳性菌为主要致病菌。临床需针对独立危险因素，通过缩短住院及发热时长、规范抗菌药物应用、加强中性粒细胞缺乏期患儿的感染防控等综合措施，对血液病患儿医院感染具有良好的预防作用，可降低NI发生风险。

  关键词： 血液病；儿童；医院感染；临床特征；危险因素; ; ; ; 

   

  Abstract: Abstract Objective : To investigate the clinical characteristics, etiological distribution and risk factors of nosocomial infection ( NI ) in hospitalized children with hematological diseases, and to provide a basis for the accurate formulation of infection prevention and control strategies. Methods A total of 3256 hospitalized children with hematological diseases admitted to the Hematology Hospital of Chinese Academy of Medical Sciences from January 2024 to December 2024 were selected as the research objects. The clinical data, distribution of infection sites and etiological characteristics of NI children were analyzed. Univariate analysis and multivariate Logistic regression analysis were used to screen independent risk factors for NI. Results A total of 313 cases of infection occurred, with an infection rate of 9.61 %. A total of 326 cases were infected, with an infection rate of 10.01 %. The infection sites were mainly bloodstream infection ( 113 cases, 34.66 % ) and respiratory tract infection ( 111 cases, 34.05 % ). A total of 180 strains of pathogenic pathogens were obtained, including 88 strains of Gram-positive bacteria ( 48.89 % ), 68 strains of Gram-negative bacteria ( 37.78 % ), 16 strains of viruses ( 8.89 % ), and 8 strains of fungi ( 4.44 % ). Multivariate analysis showed that hospitalization time > 10 days, fever time > 2 days, combined use of antibiotics and minimum neutrophil count < 0.5×109 / L were independent risk factors for NI in children ( P < 0.05 ). Conclusion The incidence of nosocomial infection in hospitalized children with hematological diseases is high, and gram-positive bacteria are the main pathogenic bacteria. In view of the independent risk factors, comprehensive measures such as shortening the length of hospitalization and fever, standardizing the application of antibiotics, and strengthening the prevention and control of infection in children with neutropenia should be taken to prevent nosocomial infection in children with hematological diseases and reduce the risk of NI.

  Key words: Blood disease; Children; Hospital infection; Clinical features; Risk factors

  提交时间：2026-04-16

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• 序号	提交日期	编号	操作
  1	2026-03-13	10.12201/bmr.202604.00126V1	下载

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