Background/Purpose: To determine the clinical characteristics and to identify relative factors of infection in patients with Systemic Lupus Erythematosus, to provide a data for making the diagnosis and preventable scheme of infection.

Methods: A retrospective review of the medical records of 3827 patients hospitalized with Systemic Lupus Erythematosus admitted in our center from January 2008 to June 2013 were performed.1290 cases were defined as infection group(IG) and 1278 of the other were defined as non-infection group(NIG).The data were analyzed with the statistics software SPSS19.0. Relative factors of infection in patients with SLE were identified with multifactor logistic regress analysis.

Results:

1. 1290 patients (33.7%) suffered at least one infection.The incidence of patients that suffered from 2 infections was 13.41% (173/1290) and the incidence was 1.70 %( 22/1290) that suffered from 3. The incidence of nosocomial infection was 22.6 %( 341/1507).

2. According to Systemic lupus erythematosus disease activity index, there are 331 stable cases, mild activity for 315 cases (24.4%), moderate activity for 306 cases (23.7%), and severe activity of 338 cases (26.2%). There are 497 cases (38.5%) with multiple system damage and 747 cases (57.91%) with single system damage;

3. the most common infection focus the respiratory tract (66.5%, including upper respiratory tract (28.1%) and lung (38.4%)), digestive tact (7.2%), Skin (7.0%), bloodstream (3.6%).

4. the most common identified pathogenic organism was gram negative bacteria (61.3%). Most of them were Escherichia coli; gram positive bacterial (22.6%). Most of them were Streptococcus pneumonia and Staphylococcus aureus; the fungi (16.2%). Most of them were Candidaalbieans.

5. Multi-factor analysis showed that the risk factors of infection in Patients with SLE included: Age, SLE damage involving the system number, SLEDAI scores, prednisone dosage of average daily, neutral grain percentage (NEUT %), platelet count (PLT), serum creatinine (Scr), total bilirubin (TIBL), blood sedimentation (ESR), c-reactive protein (CRP), immunoglobulin G (IgG), procalcitonin (PCT).

Conclusion: SLE has an increased risk for infection. The rate of of nosocomial infection is high. The respiratory tract was the most affected localization and the bacterial infection was the most common. Opportunistic pathogens and resistant bacteria were frequently seen.The older the patient was, the more system damage involved, the higher the SLEDAI score, or the more prednisone dosage was taken, the risker the patient got infection. It suggest that the patient got an infection when the proportion of neutrophils (NEUT %), platelet count (PLT), serum creatinine (Scr), total bilirubin (TIBL), aspertate aminotransferase (AST), blood sedimentation (ESR), c-reactive protein (CRP), calcitonin (PCT)  went up , immunoglobulin G (IgG)  went down.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-characteristics-and-relative-factors-of-infections-in-southern-chinese-patients-with-systemic-lupus-erythematosus/