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Current patterns of bacterial infection in myelomatosis
Abstract:
Bacterial infections were registered in 39 patients with myelomatosis during 18 months in a prospective study. The infection incidence was 0.80 infections per patient year. 81% of a total of 32 isolates were gram-negative. Urinary tract infections due to Escherichia coli were the most frequent infections. Pneumonia due to Streptococcus pneumoniae were infrequently seen compared to previous studies. Hence, the etiologic spectrum has clearly shifted from gram-positive to gram-negative bacteria in these patients. 53% of all infections were hospital-acquired, and most of these were preceded by instrumentation of the urinary tract or indwelling venous catheters. The infections were nosocomial in 7/9 cases of septicemia registered. All 4 patients who died of infection, suffered from hospital-acquired infections. Patients who attracted infections had significantly higher serum creatinine levels and higher mortality compared to the rest of the patients.
Insights
Gram-negative bacteria, particularly Escherichia coli, are increasingly causing infections in multiple myeloma patients. Hospital-acquired infections are common and linked to higher mortality rates.
Area of Science:
- Infectious Diseases
- Hematology
- Oncology
Background:
- Multiple myeloma patients are susceptible to bacterial infections.
- Previous studies indicated a different etiological spectrum of infections.
Purpose of the Study:
- To prospectively investigate the incidence and spectrum of bacterial infections in multiple myeloma patients.
- To identify the common pathogens and risk factors associated with these infections.
Main Methods:
- Prospective study over 18 months.
- Registration of bacterial infections in 39 multiple myeloma patients.
- Analysis of bacterial isolates, infection types, and acquisition sources.
Main Results:
- Infection incidence was 0.80 per patient-year.
- 81% of isolates were gram-negative, with Escherichia coli causing most urinary tract infections.
- Gram-positive bacteria like Streptococcus pneumoniae were less frequent.
- 53% of infections were hospital-acquired, often linked to instrumentation or catheters.
- Hospital-acquired infections were prevalent in septicemia cases and associated with mortality.
- Infected patients had higher serum creatinine and mortality.
Conclusions:
- The etiological spectrum of bacterial infections in multiple myeloma has shifted towards gram-negative bacteria.
- Hospital-acquired infections are a significant concern, contributing to morbidity and mortality.
- Urinary tract instrumentation and indwelling catheters are key risk factors for nosocomial infections.