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268例多发性骨髓瘤患者感染情况的分析
作者:陈智  陈月  史玉叶  陈侃侃  何正梅  王春玲 
单位:南京医科大学附属淮安第一医院 血液科, 江苏 淮安 223300
关键词:多发性骨髓瘤 医院感染 治疗 
分类号:R733.3
出版年·卷·期(页码):2018·37·第四期(602-606)
摘要:

目的:探讨多发性骨髓瘤(MM)患者感染的临床特点。方法:对2015年3月至2016年8月268例MM住院患者的临床资料进行回顾性分析。结果:216例非感染入院MM患者中42例患者发生医院感染,感染发生率为19.4%。感染部位以呼吸道为主(占59.2%);培养的病原体中革兰阴性杆菌占35.3%,真菌占35.3%(均为白假丝酵母菌),革兰阳性球菌占23.5%。并发社区感染入院MM患者有52例,同样以呼吸道感染为主(占77.8%);培养的病原体,革兰阳性球菌占37%,革兰阴性杆菌占40.7%,真菌占18.5%。入院时高ECOG评分(≥2分)、低白蛋白血症是骨髓瘤患者发生医院感染的高危因素。结论:MM患者免疫力低下,发生医院感染风险大,感染与多种因素有关。通过合理使用抗生素以及预见性的防控手段,可对感染的控制有益,能减少医院感染发生和减轻感染强度。

Objective:To investigate the clinical characteristics of infection among patients with multiple myeloma (MM). Methods:A total of 268 cases of MM hospitalized patients were retrospectively analyzed from March 2015 to August 2016. Results:Forty-two patients (19.4%) suffered from nosocomial infections pathogens mainly derived from the respiratory tract (59.2%). Fungi (Candida albicans) and Gram-negative bacilli accounted for 35.3% respectively, and Gram-positive cocci accounted for 23.5%. At the same time patients who were infected from hospital also got pathogens from the respiratory tract very often (77.8%). Gram-positive cocci accounted for 37%, Gram-negative bacilli accounted for 40.7%, and fungi accounted for 18.5%. High ECOG score at admission (≥ 2 points), and hypoalbuminemia were high risk factors for nosocomial infection in patients with myeloma. Conclusion:There is a high risk of nosocomial infection in patients with multiple myeloma, and infection is related to many factors. But through the rational use of antibiotics, as well as predictive means of prevention and control, we may reduce the intensity of infection, and reduce the incidence of nosocomial infection.

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