To analyze the pathogenic bacteria distribution, risk factors and imaging features for nosocomial infections in patients with acute myelogenous leukemia (AML) at the induced remission stage.

The data of 126 patients with AML hospitalized in our hospital from January 2010 to December 2014 were analyzed, restrospectively. The clinical data for cases with lower respiratory infection were analyzed by the single factor test and the multi-factor unconditioned Logistic regression analysis. While the imaging characteristics of pulmonary infection were analyzed.

There were 102 cases with lower respiratory tract infection among the 126 patients with AML, the infection rate was 80.9% and the infection mortality rate was 3.2%. Age > 60 years old, white blood cell count ≤ 2 × 10⁹/L and > 10 × 10⁹/L, The level of hemoglobin ≤ 60 g/L, lymphocytes count, albumin ≤ 30 g/L, chemotherapy (IA program), length of hospital stay > 30 days and PICC catheter were all the possible risk factors by single factor analysis. The level of hemoglobin ≤ 60 g/L, albumin ≤ 30 g/L and chemotherapy (IA program) were all the risk factors of respiratory infections for patients with AML by multivariate Logistic regression analysis. There were 62 cases with both lung lesions, 23 cases with right lung disorders, 17 cases with left lung lesions. There were 37 cases with Large or patchy shadows, accounting for 36.3% of all lung infection; 22 cases with nodular lesions, accounting for 21.6% of all lung infection; 19 cases had cord and ground glass flake, accounting for 18.6%; 17 cases (16.7%) had nodules and patchy total; 7 cases (6.8%) had nodules, consolidation and empty shadow. 5 cases with fungal culture-positive showed nodules merged with empty shadow, while only 2 cases (2/26) of bacterial infection showed nodules empty shadow, with significant differences (χ² = 20.44, P = 0.00).

For patients with AML remission induction, the hospital infection rate was high. Hemoglobin ≤ 60 g/L, albumin ≤ 30 g/L and chemotherapy (IA program ) were all risk factors of respiratory infection for patients with AML. The lung imaging of acute myeloid leukemia in patients with lower respiratory tract infection was diversity, nodular shadows merged with empty shadow suggests fungal infection.