title: Infections in Hospitalised Patients with Multiple Myeloma: Main Characteristics and Risk Factors.
abstract: OBJECTIVE
  Multiple myeloma is a common haematological malignancy and immune dysfunction is the hallmark of the disease. It leads to an increased infection risk, which is still a major cause of mortality. The infection spectrum and characteristics have evolved with the introduction of novel agents. An understanding of risk factors that increase susceptibility to infections is critical in fighting them. This retrospective investigation aimed to establish the incidence and main characteristics of infections in non-transplanted hospitalised myeloma patients in our department over a 3-year period, as well as factors associated with infections.
  
  
  METHODS
  A total of 240 hospitalised patients with multiple myeloma (120 males and 120 females; average age: 69 years, range: 41-89 years) who were diagnosed or treated in our department from January 2008 to December 2010 were included in this study and their data were retrospectively analysed.
  
  
  RESULTS
  Infections were identified in 17.9% of hospitalised patients. The most common pathogen found was Pseudomonas aeruginosa. The frequency of gram-positive and gram-negative pathogens was similar. In 37.2% of cases, the agent was not isolated. The most common sites of infections were the urinary system and the blood (septicemia). The frequency of infection increased with duration of disease and the rate of reinfection was 41.9%. The patients treated with bortezomib had the highest infection occurrence. Fatal outcome occurred in 9.3% of cases.
  
  
  CONCLUSIONS
  The factors associated with infections in this investigation were female sex, 3B clinical stage of disease, increased serum creatinine and ferritin levels, neutropenia, poor general condition, and presence of catheters. Myeloma patients with one or more of these mentioned risk factors should be monitored with particular care in order to decrease the incidence and severity of infective complications.
authors.forename: Toni
authors.initials: T
authors.lastname: Valković
authors.forename: Vedrana
authors.initials: V
authors.lastname: Gačić
authors.affiliation: University Hospital Centre Rijeka, Clinic of Gynaecology and Obstetrics, Rijeka, Croatia Phone: +0038551421426 E-mail: jelenaivandic@yahoo.com.
authors.forename: Jelena
authors.initials: J
authors.lastname: Ivandić
authors.forename: Božo
authors.initials: B
authors.lastname: Petrov
authors.forename: Renata
authors.initials: R
authors.lastname: Dobrila-Dintinjana
authors.forename: Elizabeta
authors.initials: E
authors.lastname: Dadić-Hero
authors.forename: Antica
authors.initials: A
authors.lastname: Načinović-Duletić
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D000069286:Bortezomib / Q000008:administration & dosage / Q000009:adverse effects; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology; D003404:Creatinine / Q000097:blood; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D004198:Disease Susceptibility; D064147:Febrile Neutropenia / Q000139:chemically induced / Q000150:complications; D005260:Female; D005293:Ferritins / Q000097:blood; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy; D009894:Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D000069286:Bortezomib; D005293:Ferritins; D003404:Creatinine