H Z Gao, L T Luo, L H Lu, X Y Zheng, T Yang, J D Hu
{"title":"[血液病恶性患者铜绿假单胞菌感染的临床特点及预后]。","authors":"H Z Gao, L T Luo, L H Lu, X Y Zheng, T Yang, J D Hu","doi":"10.3760/cma.j.cn121090-20240824-00319","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies. <b>Methods:</b> This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection. <b>Results:</b> Logistic regression analysis revealed that hospitalization days of >50 days (<i>P</i>=0.010, <i>OR</i>=3.581, 95% <i>CI</i> 1.356-9.457), history of antibiotic exposure (<i>P</i>=0.008, <i>OR</i>=4.394, 95% <i>CI</i> 1.358-6.238), more than two courses of chemotherapy before infection (<i>P</i>=0.006, <i>OR</i>=2.911, 95% <i>CI</i> 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively (<i>P</i>=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) (<i>P</i>=0.039, <i>OR</i>=5.286, 95% <i>CI</i> 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. <b>Conclusion:</b> Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 11","pages":"1028-1034"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies].\",\"authors\":\"H Z Gao, L T Luo, L H Lu, X Y Zheng, T Yang, J D Hu\",\"doi\":\"10.3760/cma.j.cn121090-20240824-00319\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies. <b>Methods:</b> This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection. <b>Results:</b> Logistic regression analysis revealed that hospitalization days of >50 days (<i>P</i>=0.010, <i>OR</i>=3.581, 95% <i>CI</i> 1.356-9.457), history of antibiotic exposure (<i>P</i>=0.008, <i>OR</i>=4.394, 95% <i>CI</i> 1.358-6.238), more than two courses of chemotherapy before infection (<i>P</i>=0.006, <i>OR</i>=2.911, 95% <i>CI</i> 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively (<i>P</i>=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) (<i>P</i>=0.039, <i>OR</i>=5.286, 95% <i>CI</i> 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. <b>Conclusion:</b> Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.</p>\",\"PeriodicalId\":24016,\"journal\":{\"name\":\"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi\",\"volume\":\"45 11\",\"pages\":\"1028-1034\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-11-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3760/cma.j.cn121090-20240824-00319\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3760/cma.j.cn121090-20240824-00319","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨血液学恶性肿瘤患者铜绿假单胞菌感染的临床特点及预后。方法:回顾性分析2019年1月1日至2021年12月31日在血液科住院的197例血液恶性肿瘤合并铜绿假单胞菌感染患者的临床资料。根据患者对碳青霉烯类药物的敏感性将患者分为易感组(CSPA感染组)和耐药组(CRPA感染组),比较两组患者临床特征的差异,分析CRPA感染的危险因素及预后。结果:Logistic回归分析显示,住院时间为bb0 ~ 50天(P=0.010, OR=3.581, 95% CI 1.356 ~ 9.457)、抗生素暴露史(P=0.008, OR=4.394, 95% CI 1.358 ~ 6.238)、感染前化疗超过2个疗程(P=0.006, OR=2.911, 95% CI 1.358 ~ 6.238)是发生CRPA的独立危险因素。CRPA和CSPA患者的死亡率分别为12.8%(18/140)和28.1% (16/57)(P=0.010)。Logistic回归分析显示,血液感染(BSI) (P=0.039, OR=5.286, 95% CI 1.091 ~ 25.621)是血液恶性肿瘤和CRPA感染死亡的独立危险因素。结论:感染前住院50天、抗生素暴露史、化疗2个疗程是CRPA感染的独立危险因素。恶性血液病合并CRPA感染死亡率高,其中BSI是恶性血液病合并CRPA感染30天死亡率的独立危险因素。
[Clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies].
Objective: This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies. Methods: This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection. Results: Logistic regression analysis revealed that hospitalization days of >50 days (P=0.010, OR=3.581, 95% CI 1.356-9.457), history of antibiotic exposure (P=0.008, OR=4.394, 95% CI 1.358-6.238), more than two courses of chemotherapy before infection (P=0.006, OR=2.911, 95% CI 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively (P=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) (P=0.039, OR=5.286, 95% CI 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. Conclusion: Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.