多发性骨髓瘤患者医院感染原因分析与控制

Causes analysis and control of nosocomial infection in patients with multiple myeloma

目的分析多发性骨髓瘤患者医院感染相关因素,为临床治疗及预防提供依据。方法回顾性分析2011年9月—2014年7月收治住院的92例多发性骨髓瘤患者的相关资料,对患者的感染情况、感染部位、病原菌分布及感染相关因素进行分析。结果 92例多发性骨髓瘤患者中有41例发生医院感染,感染率44.57%;共发生感染62例次,例次感染率67.39%;在所有感染部位中呼吸道感染发生率最高,占53.23%,胃肠道感染12例次,占19.35%,泌尿道感染发生9例次,占14.52%;分离病原菌46株,其中革兰氏阴性菌居首,24株,占52.17%,革兰氏阳性菌15株,占32.61%,7例真菌,占15.21%;贫血、营养不良、住院时间、WBC、粒缺时间及骨髓瘤细胞比例是多发性骨髓瘤医院感染的相关因素,贫血、粒缺时间及骨髓瘤细胞比例是多发性骨髓瘤患者感染的独立危险因素。结论多种原因导致的免疫缺陷是导致多发性骨髓瘤患者医院感染的重要原因,对感染的相关因素进行针对性预防对改善预后有重要作用。

Objective To analyze the related factors of nosocomial infection in patients with multiple myeloma,and provide a basis for the clinical treatment and prevention of nosocomial infection. Methods The related information of 92 hospitalized patients with multiple myeloma from September 2011—July 2014 in our hospital were analyzed retrospectively. The infection sites,distribution of pathogens and infection-related factors were analyzed. Results 41 of 92 cases were with nosocomial infection,the infection rate was 44. 57%; respiratory infection has the highest rate,accounting for 53.23%,12 cases of gastrointestinal,accounting for 19. 35%,9 cases of urinary tract infection,accounting for 14. 52%; 46 isolated pathogens included gram-negative bacteria 24 topped strains accounted for 52. 17%,Gram-positive bacteria 15,accounting for 32. 61%,7 cases of fungus,accounting for 15. 21%; The anemia,malnutrition,hospitalization time,WBC,time of granulocyte lack,and the proportion of multiple myeloma cells were the related factors of nosocomial infections.The anemia,time of granulocyte lack,and the proportion of multiple myeloma cells were the independent risk factor for infection in patients with multiple myeloma. Conclusion The immune deficiency caused by variety of causes is an important cause of nosocomial infection in patients with multiple myeloma,to analyze the infection-related factors has an important role for the targeted prevention and improve the prognosis.