202例多发性骨髓瘤医院感染临床分析

Clinical analysis of nosocomial infections in 202 patients with multiple myeloma

目的探讨多发性骨髓瘤发生医院感染的临床特征,为临床提供指导以降低医院感染率。方法回顾性分析202例多发性骨髓瘤患者发生医院感染率、感染部位、病原菌特点、感染发生与中性粒细胞及淋巴细胞数的关系。结果多发性骨髓瘤患者发生医院感染率24.75%、例次感染率为40.59%;感染部位以呼吸道为主,占53.66%;检出病原菌革兰阴性杆菌占48.98%,以肺炎克雷伯菌为主,占12.24%;革兰阳性球菌占24.49%,以葡萄球菌属为主,占18.37%;真菌占26.53%,以白色假丝酵母菌为主,占18.37%;感染率与中性粒细胞计数呈负相关,淋巴细胞计数与感染发生率成反比。结论多发性骨髓瘤极易引发医院感染,应将呼吸道感染的预防放在首位。

OBJECTIVE To explore the clinical characteristics of nosocomial infections in the patients with multiple myeloma （MM） so as to provide basis for reducing the incidemce of nosocomial infections. METHODS The clinical features including the incidence of nosocomial infections, infection sites, and the species of pathogens were analyzed retrospectively, and the correlation between the incidence of infection and the neutrophils and lymphocytes counts were observed. RESULTS The incidence rate of nosocomial infections in the patients with multiple myeloma was 24. 5% with the case-time infection rate of 40. 59%. The respiratory tract was the main infection site, accounting for 53. 66%. The gram-negative bacilli accounted for 48. 98% among the isolated pathogens in which Klebsiella pneumoniae （12. 24%） was the most common species. The gram-positive cocci accounted for 24.49%, among which Staphylococci （18.37%） was the predominant species. The fungi accounted for 26.53%, among which Candida albicans （18.37%） was the main species. The infection rates and the number of neutrophils was negatively correlated, and the number of lymphocytes was inversely proportional to the incidence of infections. CONCLUSION The nosocomial infections are prone to occur in the patients with multiple myeloma, it is necessary to attach great importance to the prevention of respiratory tract infections.