Clinical Characteristics, Microbiological and Risk Factors of Infections in Patients With Systemic Lupus Erythematosus.

Abstract

Objective: To determine risk factors, clinical and microbiological characteristics of infections in a single-center systemic lupus erythematosus (SLE) cohort.

Methods: All hospital patients in The First Affiliated Hospital of Zhengzhou University from 2019 to 2021 who meet ≥4 ACR-97 SLE criteria were identified. Patients with infection and without infection were included with a ratio of 1:2.

Results: 687 SLE patients were identified and 224 patients with infection and 448 patients without infection were included. The most common microorganisms in the infection group were Escherichia coli, Herpes zoster and Aspergillus, respectively. In the cox regression analysis, nephritis (OR 1.785; 95% CI: 1.156-2.756), diabetes(OR 6.507; 95% CI: 2.692-15.725), CD4+ T cell (OR 1.003; 95% CI: 1.002-1.004), prednisone>10 mg/day (OR 1.879; 95% CI: 1.112-3.175), immunosuppressants (OR 0.465; 95% CI: 0.310-0.697) and SLEDAI score (OR 0.866; 95% CI: 0.837-0.896) were risk factors associated with infection.

Conclusions: Bacteria was the most common infection in SLE patients with the respiratory tract being the most common site. Nephritis, diabetes, SLEDAI score were associated with infection. Monitoring CD4+ T cell can predict the infection incidence. Prednisone (>10 mg/day) and immunosuppressants increase the occurrence of infection.