Infections in patients with recent diagnosis of multiple myeloma: a single-center descriptive study in Colombia
DOI:
https://doi.org/10.21615/cesmedicina.7323Keywords:
multiple myeloma, infection, mortalityAbstract
Introduction: Although the treatment of multiple myeloma has advanced in recent years with a subsequent increase in long-term survival, early mortality remains a transcendental event, where infections may play a key role, understanding the local epidemiology may help to direct antimicrobial prophylaxis measures and impact on outcomes in the early evolution of the disease. Methods: We conducted a descriptive study including 169 patients older than 18 years hospitalized in a high-complexity health center in Medellin, Colombia, in the period between January 2012 and June 2021, with a maximum of 3 months of confirmed diagnosis of multiple myeloma. Baseline sociodemographic and clinical variables of the patients were collected, and the presence of infections, microbiological and antimicrobial isolates used were described. Results: Out of 169 patients with newly diagnosed multiple myeloma, 95 (56.2%) of the patients had some infection. Of these, respiratory and urinary tract infections were the most common (both 15.4%). The most isolated germs were gram-negative bacilli (33.7%) and gram-positive cocci (21.1%). Regarding the use of prophylaxis, most patients received antiviral 107 (63.3%), azoles 98 (58%), and few antibiotics 29 (17.2%). Regarding the time of onset of infections, patients had an average of 24 days from the time of hospital admission, and 8 days from the time of initiation of chemotherapy. In relation to all-cause mortality in the first 3 months, 24% were present and of these, 2 thirds were related to infectious processes. Conclusion: Infections in patients with newly diagnosed multiple myeloma are an important cause of mortality, despite preventive and therapeutic efforts in recent decades. A change in the epidemiology of the germs affecting these patients has been documented. Therefore, it is necessary to recognize infections in the hospital setting in multiple myeloma in order to establish local management guidelines.
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