Infections in an inpatient rheumatology unit: how big is the problem?

Patients with rheumatic diseases are at high risk of infections. As quantification and characterization of infections in daily practice is a crucial exercise to delineate strategies to overcome this problem, we aimed to describe the prevalence of infections in an inpatient rheumatology unit. A cross-sectional analysis of all patients admitted at the São João Hospital Centre Rheumatology Unit between January 1st 2012 and December 31st 2013 was performed. We found a 31.7% (n=79) period prevalence of infection and a total number of infections of 97 (1.23 infections per patient). They were the admission reason in 17.6% (n=44) and hospital acquired in 19.0% (n=15) of the cases. The urinary tract was the most commonly affected (32.0%; n=31) and Escherichia coli (17.5%; n=17) the most frequently identified infectious agent. Infection prolonged the hospital length of stay in 34.2% (n=27) of the cases but any death occurred as a direct consequence of it. Patients with infection were older, had longer rheumatic disease duration and longer hospital length of stay than those without infection. We conclude that the prevalence of infection in our inpatient population is high but most cases were non complicated, easily treated with common antibiotics and, importantly, not associated with higher lethality.