Clinical predictors for bloodstream infection in systemic lupus erythematosus

This study aimed to investigate the distribution of pathogenic bacteria and identify clinical predictors associated with bloodstream infection (BSI) in patients with systemic lupus erythematosus (SLE).

The experimental group included 43 SLE patients with BSI (SLE-BSI), who were diagnosed and treated at the First Affiliated Hospital of Sun Yat-sen University between October 2013 and June 2023. The control group consisted of 172 SLE patients without BSI (SLE-non-BSI), randomly selected at a 1:4 ratio and matched for age, gender, and ward with the case group. Logistic regression analyses of clinical data and laboratory indicators were used to identify independent clinical predictors for SLE-BSI.

The most common pathogens identified in SLE-BSI patients were Staphylococcus aureus (18.6%), Salmonella spp. (16.3%) and Escherichia coli (11.6%). Multivariate logistic regression analysis revealed that fever (OR = 4.079, 95% CI: 1.582-10.517, p = 0.004), myalgia (OR = 5.637, 95% CI: 1.363-23.318, p = 0.017), and glucocorticoid use (OR = 2.690, 95% CI: 1.041-6.948, p = 0.041) were independent clinical predictors associated with the occurrence of SLE-BSI.

For SLE patients receiving glucocorticoid therapy, the presence of myalgia and fever should raise suspicion of BSI. The findings may help optimize the clinical utility of blood culture testing, thereby facilitating the early identification of BSI in SLE patients.