Incidence and Risk of Infection in Egyptian Patients with Systemic Lupus Erythematosus

Abstract

BACKGROUNDInfection in systemic lupus erythematosus (SLE) is common and is one of the leading causes of morbidity and mortality.OBJECTIVETo study the risk and occurrence of infection in Egyptian SLE patients and to determine its characteristics.METHODSA total of 200 SLE patients were followed up for 1 year at monthly intervals, undergoing clinical and laboratory evaluation. Disease activity was assessed by SLE disease activity measurement (SLAM) score. Infections were diagnosed on basis of clinical findings, medical opinion, positive blood and urine cultures, Gram stain results, and specific serological assays as measurement of CMV and EBV antibodies.RESULTSA total of 55% of patients developed infection, 45% had one infection, and the rest had multiple infection episodes. Total number of infections was 233 infections/year, 47.2% were major and 52.8% were minor infections. Urinary tract was the most commonly involved site with bacterial infection being the commonest isolated organism (46.4%), and E. coli the commonest isolated bacteria (14.2%). There were 51 episodes caused by systemic viral infection (CMV in 25, EBV in 22, HCV in 3, and 1 in HBV).CONCLUSIONThere is a high rate of infection among SLE patients. Disease activity, leukopenia, high CRP level, positive anti-dsDNA, consumed C3, and cyclophosphamide therapy are independent risk factors for infection in SLE.

Clinical and epidemiologic characterization of patients with systemic lupus erythematosus admitted to an intensive care unit in Colombia

“…Mechanical ventilation was used in 31% of the patients for a median of 5 days, which is lower than that reported in other cohorts, where it was used between 68 and 77% of patients for an average of 10 days [7,9,20,29]. This may be due to the cause of admission in our patients in which renal involvement predominated.…”

Predictive Factors of Hospital-Acquired Bacterial Infections in Patients With Systemic Lupus Erythematosus

“…With its advantages and limitations, BUN is a marker of renal dysfunction, which affects many systems, including immune responses. 36 In the cohort study reported by Mohamed et al, 37 200 Egyptian patients with SLE were followed up for 1 year, and 233 infections of various etiologies were documented. This study found that a high CRP concentration was an independent risk factor of the development of infection.…”

Características clínicas y comorbilidades de pacientes con lupus eritematoso sistémico en niños y adultos

“…[37][38][39] Las infecciones constituyen la principal causa de mortalidad en los países en vías de desarrollo; las principales razones que se aducen, para la predisposición de los pacientes a una infección, son el tratamiento inmunosupresor y las alteraciones inmunológica propias del lupus. [40][41][42] Los niños hospitalizados con altos títulos de anti-DNA, niveles bajos del complemento y una mayor actividad de la enfermedad son más propensos a sepsis, por lo que es recomendable identificarlos por clínica y laboratorio. 43 En la medida que son detectadas más complicaciones y manifestaciones de alta actividad de la enfermedad la asociación con lupus neuropsiquiátrico es mayor; 44 afecta notablemente la calidad de vida de los pacientes y se le correlaciona con mayor riesgo de suicidio.…”