Pathogens and risk factors of healthcareassociated infection in children with acute leukemia

Abstract:

ObjectiveTo explore the main sites, pathogen distribution and risk factors of healthcareassociated infections (HAI) in children with acute leukemia, and provide scientific evidence for  prevention and treatment.MethodsData  of 828 children with acute leukemia admitted to a hospital in 2011-2012 were collected, infection site, pathogen distribution and risk factors of infection were analyzed.ResultsOf 828 patients, 184 cases and 196 times of HAI occurred with the incidence of 22.22% and 23.67%, respectively. HAI occurred mostly in respiratory tract (52.56%). A total of 96 pathogenic strains were isolated, among which gramnegative and grampositive bacteria accounted for 58.33%(n=56) and 29.17%(n=28) respectively. Univariate analysis revealed that risk factors for HAI were leukemia remission induction chemotherapy,  hospital stay ≥30 days, peripheral leukocyte count (WBC) ≤3×109/L， granulocyte count ≤0.5×109/L, and acute nonlymphocytic leukemia. Multivariate analysis revealed that hospital stay ≥30 days was independent risk factors for HAI.ConclusionChildren with acute leukemia have a high incidence of HAI, infection mainly occurs in respiratory system, and gramnegative bacteria are major pathogens. The incidence of HAI is correlated with remission induction chemotherapy,long length of hospital stay, low WBC, low number of neutrophils, and acute myeloid leukemia.