Objective: To explore the characteristics of infection in patients with myelodysplastic syndromes (MDS), risk factors of serious infection, and their correlation with curative effect.
Methods: The clinical data of 92 newly diagnosed MDS patients with nosocomial infection from January 2016 to June 2020 in our hospital were retrospectively analyzed.
Results: A total of 306 courses of treatment were completed in 92 newly diagnosed MDS patients. The infection rate was the highest in the first course of treatment (84.8%, 78/92), and then decreased gradually. The top three infection sites were lung, upper respiratory tract, and gastrointestinal tract. A total of 90 strains of pathogenic bacteria were detected, of which 33.4% (30/90) were gram-negative bacilli, 23.3% (21/90) were gram-positive cocci, 23.3% (21/90) were fungi, and 20.0% (18/90) were viruses. The serious infection rate among 92 patients with MDS was 22.8% (21/92). Multivariate analysis showed that neutrophil deficiency>7 days (OR=10.875, 95%CI: 2.747-43.051, P=0.001) was an independent risk factor for serious infection in MDS patients. Compared with non-severe infection group, the total effective rate of severe infection group was lower (90.9% vs 63.6%, χ2=4.393, P<0.05).
Conclusion: The infection rate of MDS patients is high in the first course of treatment, and the most common infection site is the lung. Gram-negative bacteria is the most common pathogen. MDS patients with neutrophil deficiency>7 days have a high risk of serious infection and poor efficacy.
题目: 初诊骨髓增生异常综合征患者感染的临床特征 及其与疗效的关系.
目的: 探讨骨髓增生异常综合征(MDS)患者感染的特点、重症感染的危险因素及其与疗效的关系.
方法: 回顾性分析2016年1月至2020年6月本院血液科病房收治的92例院内感染的初诊MDS患者临床资料.
结果: 92例初诊MDS患者共完成306个疗程，以第一疗程感染率最高（84.8%，78/92），后逐渐下降。感染部位前3位依次是肺部、 上呼吸道、胃肠道。共检出病原菌90株，其中革兰阴性杆菌占33.3％（30/90），革兰阳性球菌占23.3％（21/90），真菌占23.3％（21/90），病毒占20.0％（18/90）。92例MDS患者中重症感染率为22.8%（21/92）。多因素分析显示，中性粒细胞缺乏时间>7 d（OR=10.875，95%CI:2.747-43.051，P=0.001）是MDS患者重症感染的独立危险因素。与非重症感染组相比，重症感染组总有效率较差（90.9％ vs 63.6％，χ2=4.393，P<0.05）.
结论: MDS患者第一疗程感染率高，最常见感染部位是肺部，病原菌以革兰阴性杆菌多见。中性粒细胞缺乏时间>7 d的MDS患者重症感染风险高，疗效差.
Keywords: efficacy; myelodysplastic syndrome; risk factor; septic shock; severe infection.