多发性骨髓瘤患者社区感染和院内感染间的差异

目的:总结多发性骨髓瘤(MM)患者社区感染和院内感染的特点,了解2类感染间的差异,以期对2类感染在抗生素的选择上有所帮助。方法:回顾性分析近5年来我院多发性骨髓瘤(MM)患者社区感染和院内感染情况。结果:MM患者47例,发生感染20例,占42.55%,其中院内感染16例(80%),痰培养铜绿假单胞菌ESBLs( )1例、肠球菌1例、白色念珠菌1例、光滑念珠菌1例;中段尿培养大肠埃希氏菌ESBLs( )1例、类星形念珠菌1例;血培养肺炎链球菌1例;社区感染4例(20%);肺结核并铜绿假单胞菌ESBLs(-)1例、铜绿假单胞菌ESBLs(-)1例、白色念珠菌1例。结论:我院近5年MM患者的感染以院内感染为主,细菌与真菌约各占一半,细菌以ESBLs阳性为主;社区感染中细菌、真菌、结核均可出现,细菌感染ESBLs为阴性。

Difference between community infections and nosocomial infections on patients with multiple myeloma

Objective:To summarize the characteristics of community infections and nosocomial infections on patients with multiple myeloma, and distinguish the differences between these two types of infections, thus facilitate better choice of antibiotics.Method:The clinical data of these two kinds of infections were retrospectively analyzed on patients with multiple myeloma in our hospital during recent five years.Result:Among 47 patients with mutiple myeloma, 20 cases ( 42.55%) developed infections. 80% of them (16 cases) were nosocomail infections, including 1 case of pseudomonas aeruginasu ESBLs( ), 1 case of enterococcus, and 2 cases of candiaiasis in sputum culture, 1 case of Escherichia ccli ESBLs( ) and 1 case of candidiasis in mid-stream urine culture, and 1 case of streptococcus pneumoniae in blood culture. 20% of them (4 cases) were commnuity infections, including 1 case of pulmonary tuberculosis and pseudomonas aeruginasu ESBLs(-), 1 case of pseudomonas aeruginasu ESBL(-), and 1 case of candidiasis.Conclusion:Nosocomail infection is the main infection on patients with multiple myeloma in our hospital during recent five years. The incidencerate of bacteria and fungi nosocomail infections both are one half, and bacteria infections are mainly with ESBLs( ); while in community infections, bacteria and fungi and tuberculosis are all found, and bacteria infections are with ESBL(-).