Bacteremia in Patients with Systemic Lupus Erythematosus.
- Author:
Jun Ki MIN
1
;
Do June MIN
;
Youn Sik HONG
;
Sang Heon LEE
;
Sung Hwan PARK
;
Chul Soo CHO
;
Ho Youn KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea.
- Publication Type:Original Article
- Keywords:
Systemic lupus erythematosus;
Bacteremia
- MeSH:
Bacillus;
Bacteremia*;
Causality;
Coagulase;
Enterococcus faecalis;
Female;
Humans;
Listeria monocytogenes;
Logistic Models;
Lupus Erythematosus, Systemic*;
Lupus Nephritis;
Medical Records;
Mirabilis;
Odds Ratio;
Pneumonia;
Retrospective Studies;
Salmonella;
Streptococcus pneumoniae;
Streptococcus pyogenes;
Thrombocytopenia;
Viridans Streptococci
- From:The Journal of the Korean Rheumatism Association
2000;7(4):381-389
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To determine the causative organisms and predisposing factors of bacteremia in patients with systemic lupus erythemaosus (SLE). METHODS: We retrospectively evaluated medical records of 358 patients with SLE who were followed in Kangnam St. Mary? Hospital from 1992 to 1997. Bacteremic SLE patients were compared to non-bacteremic SLE patients in terms of laboratory and clinical variables. RESULTS: Twenty-nine episodes of bacteremia in 27 patients with SLE (26 women, 1 man) were identified. The episode of community acquired bacteremia (n=21, 72.4%) was more frequent than that of hospital acquired bacteremia (n=8, 27.6%). Isolated bacterial organisms from blood were as follows: gram negative organisms (n=14); Salmonella species (n=8), E. coli (n=4), P. mirabilis (n=1), K. pneumonia (n=1). gram positive organisms (n=15); S. aureus (n=6), Streptococcus pneumoniae (n=2), coagulase negative Staphylococci (n=2), Bacillus species (n=1), Streptococcus viridans (n=1), Streptococcus pyogenes (n=1), Enterococcus faecalis (n=1), Listeria monocytogenes (n=1). SLE was the most common underlying condition among Salmonella bacteremic patients. One of twenty seven bacteremic SLE patients (3.8%) died in spite of antibiotic therapy. Logistic regression analysis of the laboratory and clinical variables between bacteremic SLE patients and non-bacteremic SLE patients (n=140) showed that bacteremic SLE patients were more frequently associated with thrombocytopenia (p=0.008, odds ratio (OR)=7.8, 95% confidence interval (CI), 1.7 to 35.9), lupus nephritis (p=0.023, OR=5.3, 95% CI, 1.1 to 26.8), and high dose steroid therapy (prednisolone > 0.5mg/kg/day, p=0.008, OR=12.1, 95% CI 2.5 to 58.6) than non-bacteremic SLE patients. CONCLUSION: Our data suggested that Salmonella was the single most frequent isolate from the blood of SLE patients. Lupus nephritis and high dose steroid therapy were independent predisposing factors for the development of bacteremia in SLE patients.
