Urinary Tract Infection in Systemic Lupus Erythematosus: Report from A Developing Country

Urinary tract infection (UTI) is one of the important causes of morbidity and mortality in Systemic lupus erythematosus (SLE). To calculate the frequency, organism and risk factors for UTI in SLE. This observational study was conducted in the lupus clinic in the department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2012 to January 2014. Total 169 diagnosed SLE patients were enrolled consecutively. Urinary symptoms positive patients were considered as case and symptoms negative were considered as controlled. The patients having DM, Recurrent UTI and unable to participant were excluded. Urinary symptoms including demographic variable, disease activity index- Systemic Lupus Erythematosus Disease activity index (SLEDAI), organ damage index Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) were evaluated. Dose, duration and cumulative dose of steroid, HCQ, MMF, azathioprine and cyclophosphamide were evaluated for risk factor of UTI. Serum C3, C4, CRP, ANA, anti-ds DNA, CBC, urine routine examination with culture and sensitivity were done. Out of 169 patients 19 patients excluded in this series. Forty patients had UTI and rate of UTI was 28.57%. The most common organism was E coli and it was 52.5%. High disease activity index (SLEDAI), severe organ damage index (SLICC score), Lupus nephritis and cyclophosphamide were found risk factor for UTI by Bi-variate analyses. Use of cyclophosphamide in SLE patient was found as significant risk factor in multivariate analyses. Frequency of UTI in SLE was quiet high. Past suffering from Lupus nephritis and use of Cyclophosphamide were notable risk factor for UTI.