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Clinical Characteristics, Microbiological and Risk Factors of Infections in Patients With Systemic Lupus
Guanhua Li1, Xiaojing Liu1, Jiakang Zhao1
1Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Journal of Community Hospital Internal Medicine Perspectives
|January 27, 2025
Summary
Infections in systemic lupus erythematosus (SLE) patients are often bacterial, affecting the respiratory tract. Key risk factors include nephritis, diabetes, and high-dose prednisone, while monitoring CD4+ T cells aids prediction.
Area of Science:
- Rheumatology
- Infectious Diseases
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with increased susceptibility to infections.
- Understanding infection risk factors in SLE patients is crucial for improving clinical outcomes.
Purpose of the Study:
- To identify risk factors and characterize clinical and microbiological features of infections in a single-center SLE cohort.
- To analyze associations between patient characteristics and infection development.
Main Methods:
- Retrospective analysis of 687 SLE patients from 2019-2021 meeting ACR-97 criteria.
- Inclusion of 224 infected patients and 448 non-infected controls (1:2 ratio).
- Cox regression analysis to determine risk factors for infection.
Main Results:
- The most common pathogens were Escherichia coli, Herpes zoster, and Aspergillus.
- Significant risk factors included nephritis (OR 1.785), diabetes (OR 6.507), elevated CD4+ T cell count (OR 1.003), and prednisone >10 mg/day (OR 1.879).
- Immunosuppressants (OR 0.465) and higher SLEDAI scores (OR 0.866) were associated with infection risk.
Conclusions:
- Bacterial infections, particularly in the respiratory tract, are most common in SLE patients.
- Nephritis, diabetes, and SLEDAI scores are significant infection risk factors.
- Monitoring CD4+ T cells and judicious use of prednisone and immunosuppressants are important for infection prevention in SLE.
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