Background: No robust data assesses the risk of all-cause death and cardiovascular (CV) events in multiple myeloma (MM) patients. Patients and Methods: From 1 January to 31 December 2013, 3,381,472 ...adults were hospitalised (for any reason) in French hospitals. We identified 15,774 patients diagnosed with known MM at baseline. The outcome analysis (all-cause death, CV death, myocardial infarction (MI), ischaemic stroke, or hospitalization for bleedings) was performed with follow-ups starting at the time of the last event. For each MM patient, a propensity score-matched patient without MM was selected. Results: The mean follow-up in the propensity-score-matched population was 3.7 ± 2.3 years. Matched patients with MM had a higher risk of all-death (yearly rate 20.02 vs. 11.39%) than patients without MM. No difference was observed between the MM group and no-MM group for CV death (yearly rate 2.00 vs. 2.02%). The incidence rate of MI and stroke was lower in the MM group: 0.86 vs. 0.97%/y and 0.85 vs. 1.10%/y, respectively. In contrast, MM patients had a higher incidence rate of rehospitalization for major bleeding (3.61 vs. 2.24%/y) and intracranial bleeding (1.03 vs. 0.84%/y). Conclusions: From a large nationwide database, we demonstrated that MM patients do not have a higher risk of CV death or even a lower risk of both MI and ischaemic stroke. Conversely, MM patients had a higher risk of both major and intracranial bleedings, highlighting the key issue of thromboprophylaxis in these patients.
Achromobacter
spp. are worldwide emerging opportunistic pathogens in CF patients, able to chronically colonize the respiratory tract. Apart from regular consultations at the hospital CF center, ...patients spend most of their time at home. Colonization from nonhuman sources has been suggested, but the presence of
Achromobacter
spp. in CF patients' homes has not been explored. The domestic environments of CF patients chronically colonized by
Achromobacter
, especially wet environments, host several opportunistic pathogens, including a large diversity of
Achromobacter
species and genotypes. However,
Achromobacter
genotypes colonizing the patients were not detected in their domestic environments, making it unlikely that a shuttle between environment and CF airways is involved in persisting colonization. This also suggests that once the bacteria have adapted to the respiratory tract, their survival in the domestic environment is presumably impaired. Nevertheless, measures for reducing domestic patient exposure should be targeted on evacuation drains, which are frequently contaminated by CF opportunistic pathogens.
Achromobacter
spp. are nonfermentative Gram-negative bacilli considered emergent pathogens in cystic fibrosis (CF). Although some cross-transmission events between CF patients have been described,
Achromobacter
strains were mostly patient specific, suggesting sporadic acquisitions from nonhuman reservoirs. However, sources of these emergent CF pathogens remain unknown. A large collection of specimens (
n
= 273) was sampled in the homes of 3 CF patients chronically colonized by
Achromobacter xylosoxidans
with the aim of evaluating the potential role of domestic reservoirs in sustaining airway colonization of the patients. Samples were screened for the presence of
Achromobacter
by using genus-specific molecular detection. Species identification, multilocus genotypes, and antimicrobial susceptibility patterns observed for environmental isolates were compared with those of clinical strains. Patient homes hosted a high diversity of
Achromobacter
species (
n
= 7), including
Achromobacter mucicolens
and
A. animicus
, two species previously isolated from human samples only, and genotypes (
n
= 15), all showing an overall susceptibility to antimicrobial agents.
Achromobacter
strains were mostly isolated from indoor moist environments and siphons, which are potential reservoirs for several CF emerging pathogens.
A. xylosoxidans
, the worldwide prevalent species colonizing CF patients, was not the major
Achromobacter
species inhabiting domestic environments.
A. xylosoxidans
genotypes chronically colonizing the patients were not detected in their household environments. These results support the notions that the domestic environment could not be incriminated in sustained patient colonization and that after initial colonization, the environmental survival of
A. xylosoxidans
clones adapted to the CF airways is probably impaired.
IMPORTANCE
Achromobacter
spp. are worldwide emerging opportunistic pathogens in CF patients, able to chronically colonize the respiratory tract. Apart from regular consultations at the hospital CF center, patients spend most of their time at home. Colonization from nonhuman sources has been suggested, but the presence of
Achromobacter
spp. in CF patients' homes has not been explored. The domestic environments of CF patients chronically colonized by
Achromobacter
, especially wet environments, host several opportunistic pathogens, including a large diversity of
Achromobacter
species and genotypes. However,
Achromobacter
genotypes colonizing the patients were not detected in their domestic environments, making it unlikely that a shuttle between environment and CF airways is involved in persisting colonization. This also suggests that once the bacteria have adapted to the respiratory tract, their survival in the domestic environment is presumably impaired. Nevertheless, measures for reducing domestic patient exposure should be targeted on evacuation drains, which are frequently contaminated by CF opportunistic pathogens.
spp. are nonfermentative Gram-negative bacilli considered emergent pathogens in cystic fibrosis (CF). Although some cross-transmission events between CF patients have been described,
strains were ...mostly patient specific, suggesting sporadic acquisitions from nonhuman reservoirs. However, sources of these emergent CF pathogens remain unknown. A large collection of specimens (
= 273) was sampled in the homes of 3 CF patients chronically colonized by
with the aim of evaluating the potential role of domestic reservoirs in sustaining airway colonization of the patients. Samples were screened for the presence of
by using genus-specific molecular detection. Species identification, multilocus genotypes, and antimicrobial susceptibility patterns observed for environmental isolates were compared with those of clinical strains. Patient homes hosted a high diversity of
species (
= 7), including
and
, two species previously isolated from human samples only, and genotypes (
= 15), all showing an overall susceptibility to antimicrobial agents.
strains were mostly isolated from indoor moist environments and siphons, which are potential reservoirs for several CF emerging pathogens.
, the worldwide prevalent species colonizing CF patients, was not the major
species inhabiting domestic environments.
genotypes chronically colonizing the patients were not detected in their household environments. These results support the notions that the domestic environment could not be incriminated in sustained patient colonization and that after initial colonization, the environmental survival of
clones adapted to the CF airways is probably impaired.
spp. are worldwide emerging opportunistic pathogens in CF patients, able to chronically colonize the respiratory tract. Apart from regular consultations at the hospital CF center, patients spend most of their time at home. Colonization from nonhuman sources has been suggested, but the presence of
spp. in CF patients' homes has not been explored. The domestic environments of CF patients chronically colonized by
, especially wet environments, host several opportunistic pathogens, including a large diversity of
species and genotypes. However,
genotypes colonizing the patients were not detected in their domestic environments, making it unlikely that a shuttle between environment and CF airways is involved in persisting colonization. This also suggests that once the bacteria have adapted to the respiratory tract, their survival in the domestic environment is presumably impaired. Nevertheless, measures for reducing domestic patient exposure should be targeted on evacuation drains, which are frequently contaminated by CF opportunistic pathogens.
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