摘要
目的探讨老年多发性骨髓瘤(MM)化疗病人医院感染的部位、病原菌分类及影响因素。方法回顾性分析286例老年MM化疗病人医院感染的临床资料,分析老年MM化疗病人医院感染部位的构成、病原菌分布及耐药率;通过多因素Logistic回归分析老年MM化疗病人医院感染的危险因素。结果老年MM化疗病人医院感染病原菌革兰阴性菌占54.79%,革兰阳性菌占31.38%,真菌占13.83%,其中65.77%为呼吸系统感染。肺炎克雷伯菌、大肠埃希菌为常见的革兰阴性病原菌,分别占18.62%和15.43%,金黄色葡萄球菌、表皮葡萄球菌为常见的革兰阳性病原菌,分别占13.30%和11.17%。肺炎克雷伯菌、大肠埃希菌对亚胺培南耐药率均为0。表皮葡萄球菌、金黄色葡萄球菌对呋喃妥因、万古霉素、替考拉宁、利奈唑胺、替加环素的耐药率均为0。BMI≥23、合并DM、合并肾功能不全、粒细胞减少、血清白蛋白<30 g/L、ISS分期Ⅲ期是老年MM化疗病人医院感染的危险因素(P<0.05)。结论老年MM化疗病人医院感染的发生率高,病原学调查及危险因素的评估对医院感染防控措施的制定有一定的指导意义。
Objective To investigate the infection site,pathogens and risk factors of the elderly patients with multiple myeloma(MM)undergoing chemotherapy.Methods The clinical data of 286 elderly patients with MM undergoing chemotherapy were retrospectively analyzed.149 patients with nosocomial infection were divided into infection group and 137 patients without nosocomial were divided into non-infection group.The composition of infection sites,pathogens and drug resistance rates were analyzed.The risk factors of nosocomial infection in elderly patients with MM undergoing chemotherapy were analyzed by multivariate Logistic regression.Result In all nosocomial infection,gram-negative bacteria accounted for 54.79%,gram-positive bacteria accounted for 31.38%and fungi accounted for 13.83%,and 65.77% of infections sites were respiratory infections.Klebsiella pneumoniae and Escherichia coli were common gram-negative pathogens,accounting for 18.62% and 15.43% respectively.Staphylococcus aureus and Staphylococcus epidermidis were common gram-positive pathogens,accounting for 13.30% and 11.17% respectively.The resistance rates of Klebsiella pneumoniae and Escherichia coli to imipenem was 0.The resistance rates of Staphylococcus epidermidis and Staphylococcus aureus to furantoin,vancomycin,teicoplanin,linezolid and tegacycline were 0.BMI≥23,diabetes mellitus,renal insufficiency,granulocytopenia,albumin<30g/L,ISS stageⅢwere risk factors for nosocomial infection in elderly patients with MM undergoing chemotherapy(P<0.05).Conclusions The incidence of nosocomial infection in elderly patients with MM undergoing chemotherapy is pretty high.The investigation of etiology and the evaluation of risk factors have certain guiding significance for the formulation of prevention and control measures of nosocomial infection.
作者
唐荣芳
董敏
伍志梅
孔令珍
徐淑娟
唐爱林
聂雨薇
TANG Rong-fang;DONG Min;WU Zhi-mei;KONG Ling-zhen;XU Shu-juan;TANG Ai-lin;NIE Yu-wei(Department of Hematology,Affiliated Hospital of Guilin Medical College,Guilin 541001,China)
出处
《实用老年医学》
CAS
2020年第2期125-129,共5页
Practical Geriatrics
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170850)
