非霍奇金淋巴瘤医院感染病原菌及其发生风险列线图模型的建立

Analysis of pathogens causing nosocomial infection and establishment of risk nomogram model in non-Hodgkin’s lymphoma patients

  • 摘要: 目的 探讨非霍奇金淋巴瘤(NHL)患者医院感染的病原菌分布及其发生风险列线图模型的建立。方法 回顾性分析2017年12月-2019年12月南通大学附属医院收治的313例NHL住院患者进行调查,分析患者的临床资料对医院感染的影响,分析病原菌的分布特点,并根据筛选出的危险因素建立列线图预测模型。结果 NHL患者医院感染以呼吸道感染为主,共检出革兰阴性菌23株,革兰阳性菌14株和真菌11株。年龄≥60岁、糖尿病、肺部基础疾病、住院时间≥30 d、侵入性操作及白细胞计数<2.0×109/L是NHL患者医院感染的独立危险因素。列线图模型验证结果显示,预测值同实测值基本一致,一致性指数(C-index)0.751(95%CI:0.714~0.788)。结论 呼吸道和革兰阴性菌分别是NHL患者医院感染最常见的部位和菌种。基于NHL患者医院感染危险因素建立的列线图模型有良好的预测能力和精确度。

     

    Abstract: OBJECTIVE To investigate the distribution of pathogens causing nosocomial infection in patients with non-Hodgkin’s lymphoma(NHL) and the establishment of risk nomogram model. METHODS A survey of 313 NHL inpatients admitted to the Nantong University Affiliated Hospital from Dec 2017 to Dec 2019 was conducted to analyze the impact of the patients’ clinical data on nosocomial infections, analyze the distribution characteristics of pathogenic bacteria, and screen out risk factors to establish a nomogram prediction model. RESULTS Nosocomial infections of NHL patients were mainly respiratory tract infections. A total of 23 stains of Gram-negative bacteria, 14 stains of Gram-positive bacteria and 11 stains of fungi were detected. Age ≥60 years, diabetes, underlying lung diseases, hospitalization time ≥30 days, invasive procedures, and white blood cell count <2.0×109/L were independent risk factors for nosocomial infection in NHL patients. The verification result of the nomogram model showed that the predicted value was basically equivalent to the measured value, and the consistency index(C-index) was 0.751(95%CI: 0.714~0.788). CONCLUSION Respiratory tract are the most common nosocomial infection sites and gram-negative bacteria are the main bacterial species in NHL patients. The nomogram model based on nosocomial infection risk factors for NHL has good predictive ability and accuracy.

     

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