Changing patterns of infections in patients with multiple myeloma.
A total of 59 infections were encountered in 29/46 patients with multiple myeloma (MM). Most infections arose in the urinary tract (31%), respiratory tract (29%), followed by blood (12%), oropharynx (12%), skin and soft tissue (7%). Gram-negative bacilli were identified in 51% of infections, most common being Enterobacteriaceae and Haemophilus influenzae. Gram-positive organisms were responsible for 7% of infections. 24% of patients with urinary tract infections had signs of cord compression Absolute lymphopenia was common, and was seen in 65% of patients with urinary infections, 75% of respiratory infections, and 86% of septicemic patients. In contrast, granulocytopenia was mainly observed in patients with septicemia (71%), followed by those with respiratory infections (31%). All patients were on cytotoxic chemotherapy, and most were hypoglobulinemic. About one third of septicemias, and one half of urinary and respiratory infections, respectively, were hospital-acquired. Results indicate that the current pattern of infections in MM seems to favor gram-negative organisms. The role of predisposing factors in the pathogenesis of infections in these patients is discussed.
D000368:Aged; D001424:Bacterial Infections / Q000209:etiology*; D003428:Cross Infection / Q000453:epidemiology; D004756:Enterobacteriaceae Infections / Q000453:epidemiology; D005260:Female; D006088:Gram-Negative Aerobic Bacteria; D006192:Haemophilus Infections / Q000453:epidemiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D012141:Respiratory Tract Infections / Q000453:epidemiology; D018805:Sepsis / Q000276:immunology / Q000401:mortality; D014552:Urinary Tract Infections / Q000453:epidemiology