Clinical and bacteriologic study of eighty-six patients with systemic lupus erythematosus complicated by infections

To investigate the clinical and bacteriologic features of patients with systemic lupus erythematosus (SLE) complicated by bacterial and/or fungal infections.

Statistical analysis was made on basis of the clinical and bacteriologic data of 86 patients with SLE complicated by bacterial and/or fungal infections.

One hundred and thirty-three episodes of infections occurred in 86 patients with SLE, in which 51.13% were nosocomial infections and 76.69% occurred in the blood system, respiratory tract, lungs and urinary tract. Gram-negative bacilli, gram-positive cocci, fungal and other bacterial infections accounted for 39.85%, 31.58%, 18.80% and 9.77%, respectively. In the bacterial infections, 18.52% were caused by L-form bacteria and more than 60% of the patients had no apparent toxic manifestations. The odds ratio (OR) of infection increased significantly in patients with damaged functions of the heart, lungs and kidneys, and in those who received high-dosage steroids.

Patients with SLE tend to develop nosocomial infections with gram-negative bacilli which are the most common pathogens. The clinical manifestations of the infection are atypical. Careful inspection and monitoring, timely collecting the specimens for L-form bacterial culture can reduce misdiagnosis and missed diagnosis of the infection.