Bacteremia in systemic lupus erythematosus: Risk factors, clinical and microbiological characteristics, and outcomes in the largest single-center retrospective cohort in Japan

Abstract

Background In patients with systemic lupus erythematosus (SLE), infections, especially bacteremia, can occur throughout the course of the disease and are often fatal. We evaluated the characteristics of patients with bacteremia and SLE. Methods In this retrospective single-center observational study, we analyzed bacteremia in 65 patients with SLE. We compared the group that survived to the group that died. To compare demographic and clinical characteristics between groups, the Mann–Whitney U test was used for non-normally distributed variables. Categorical variables were compared using Fisher’s exact test. Results The median observation period was 39 (interquartile range: 6–74) months. The median age was 54 (43–64) years. Patients consisted of six males and 59 females. In 49 cases, the patient survived. In 16 cases, the patient died. The dead group was older, with lower Glasgow Coma Scale scores, higher sequential organ failure assessment (SOFA) scores, and lower fibrinogen levels. Conclusion When physicians encounter patients with suspected bacteremia, they should pay attention to the consciousness assessment and SOFA score, and be aware of infections caused by common microorganisms and opportunistic infections.

A Framework to Overcome Challenges in the Management of Infections in Patients with Systemic Lupus Erythematosus

“…Klebsiella and pseudomonas species may cause urine tract infections related bacteremia in SLE that are associated with shortened survival rate. 19 …”

“…Klebsiella and pseudomonas species may cause urine tract infections related bacteremia in SLE that are associated with shortened survival rate. 19 Salmonella enterica infections are more frequent among SLE subjects as compared to the general population causing a spectrum of syndromes including gall bladder infection and bacteremia. 20 Atypical presentations of Salmonella species infections in SLE patients include osteomyelitis of long bones, septic arthritis, soft tissue abscess, meningitis, typhoid https://doi.org/10.2147/OARRR.S295036…”