多发性骨髓瘤患者医院获得性感染200例临床分析

IF 1.6 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
American journal of translational research Pub Date : 2025-07-25 eCollection Date: 2025-01-01 DOI:10.62347/ZGYB9556
Hece Cai, Fugui Sun, Weihua Shen, Xianghai Bian
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引用次数: 0

摘要

目的:探讨多发性骨髓瘤患者医院获得性感染(HAIs)的临床特点。方法:对在嘉兴市海盐县人民医院治疗的200例多发性骨髓瘤患者进行回顾性分析。记录HAIs的发病率、感染部位和致病菌。根据是否存在HAIs将患者分为感染组(n=37)和非感染组(n=163)。根据随访结果进一步分为复发组(n=76)和非复发组(n=124)。分析多发性骨髓瘤患者HAIs相关危险因素,评估血清免疫球蛋白A (IgA)和免疫球蛋白G (IgG)水平对多发性骨髓瘤复发的预测价值。结果:200例多发性骨髓瘤患者中,HAIs发生率为18.5%。呼吸道是最常见的感染部位,以革兰氏阴性杆菌为主。多因素logistic回归分析发现,中性粒细胞减少、年龄≥60岁、化疗、低血清白蛋白水平、高修订国际分期系统(R-ISS)分期、体重指数(BMI)升高和合并糖尿病是多发性骨髓瘤治疗后感染的重要危险因素。结论:多发性骨髓瘤患者治疗后发生HAIs的风险增加,尤其是革兰氏阴性杆菌引起的呼吸道感染。此外,血清IgA和IgG水平可作为预测疾病复发的可靠生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical analysis of hospital-acquired infections in patients with multiple myeloma: a study of 200 cases.

Objective: To investigate the clinical characteristics of hospital-acquired infections (HAIs) in patients undergoing treatment for multiple myeloma.

Methods: A retrospective analysis was conducted on 200 patients with multiple myeloma treated at Haiyan County People's Hospital in Jiaxing. The incidence rate, sites of infection, and causative pathogens of HAIs were recorded. Patients were divided into an infection group (n=37) and a non-infection group (n=163) based on the presence of HAIs. According to follow-up outcomes, they were further classified into a recurrence group (n=76) and a non-recurrence group (n=124). Risk factors associated with HAIs in patients with multiple myeloma were analyzed, and the predictive value of serum immunoglobulin A (IgA) and immunoglobulin G (IgG) levels for the recurrence of multiple myeloma was assessed.

Results: Among the 200 patients with multiple myeloma, the incidence of HAIs was 18.5%. The respiratory tract was the most commonly affected site, with Gram-negative bacilli being the predominant pathogens. Multivariate logistic regression analysis identified neutropenia, age ≥60 years, chemotherapy, low serum albumin levels, high Revised International Staging System (R-ISS) stage, elevated body mass index (BMI), and comorbid diabetes mellitus as significant risk factors for infection following multiple myeloma treatment (all P<0.05). In addition, receiver operating characteristic (ROC) analysis revealed that serum IgA and IgG levels were strong predictors for recurrence in patients with multiple myeloma, with area under the curve (AUC) values of 0.936 and 0.914, respectively. IgA showed a sensitivity of 97.8% and specificity of 93.5%, while IgG demonstrated a sensitivity of 83.3% and specificity of 80.0%.

Conclusion: Patients with multiple myeloma are at increased risk of developing HAIs after treatment, particularly respiratory infections caused by Gram-negative bacilli. Moreover, serum IgA and IgG levels may serve as reliable biomarkers for predicting disease recurrence.

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American journal of translational research
American journal of translational research ONCOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
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