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VIENNA — Patients with systemic lupus erythematosus experience an exceptionally high rate of major infections, Irene E.M. Bultink, M.D., reported at the annual European congress of rheumatology.
In her retrospective series of 103 unselected SLE patients, one-half experienced a collective total of 115 infections—not including lower urinary tract infections—during their mean 7-year disease duration.
Of these infections, 37% were classified as major in that they required hospitalization and intravenous antibiotics. The most common sites of major infections were the lower respiratory tract (33%), systemic infections (19%), and the gastrointestinal tract (12%), said Dr. Bultink, a rheumatologist at Slotervaart Hospital, Amsterdam.
Staphylococcus aureus was identified as the causal organism in 16% of major infections, making it the No. 1 culprit microorganism in severe episodes.
In a multivariate regression analysis, the significant independent risk factors for development of major infections were the presence of IgG anticardiolipin antibodies; leukopenia during the disease course; use of methotrexate at any time in treating SLE; and longer disease duration.
Turning to the 115 infections in the group as a whole, microorganisms were isolated in 50% of cases. The single most common type of infection was herpes zoster skin eruption at 16% of all infections.
Of infections in the SLE patients, 29% involved the skin and/or mucosa, 22% involved the lower respiratory tract, and 14% involved the upper respiratory tract, she said at the meeting sponsored by the European League Against Rheumatism.
Five patients developed opportunistic infections. There were two cases of Candida albicans esophagitis; one of sepsis from cytomegalovirus and C. albicans; one case of sinusitis caused by Aspergillus fumigatus; and a Klebsiella pneumoniae pneumonia.
VIENNA — Patients with systemic lupus erythematosus experience an exceptionally high rate of major infections, Irene E.M. Bultink, M.D., reported at the annual European congress of rheumatology.
In her retrospective series of 103 unselected SLE patients, one-half experienced a collective total of 115 infections—not including lower urinary tract infections—during their mean 7-year disease duration.
Of these infections, 37% were classified as major in that they required hospitalization and intravenous antibiotics. The most common sites of major infections were the lower respiratory tract (33%), systemic infections (19%), and the gastrointestinal tract (12%), said Dr. Bultink, a rheumatologist at Slotervaart Hospital, Amsterdam.
Staphylococcus aureus was identified as the causal organism in 16% of major infections, making it the No. 1 culprit microorganism in severe episodes.
In a multivariate regression analysis, the significant independent risk factors for development of major infections were the presence of IgG anticardiolipin antibodies; leukopenia during the disease course; use of methotrexate at any time in treating SLE; and longer disease duration.
Turning to the 115 infections in the group as a whole, microorganisms were isolated in 50% of cases. The single most common type of infection was herpes zoster skin eruption at 16% of all infections.
Of infections in the SLE patients, 29% involved the skin and/or mucosa, 22% involved the lower respiratory tract, and 14% involved the upper respiratory tract, she said at the meeting sponsored by the European League Against Rheumatism.
Five patients developed opportunistic infections. There were two cases of Candida albicans esophagitis; one of sepsis from cytomegalovirus and C. albicans; one case of sinusitis caused by Aspergillus fumigatus; and a Klebsiella pneumoniae pneumonia.
VIENNA — Patients with systemic lupus erythematosus experience an exceptionally high rate of major infections, Irene E.M. Bultink, M.D., reported at the annual European congress of rheumatology.
In her retrospective series of 103 unselected SLE patients, one-half experienced a collective total of 115 infections—not including lower urinary tract infections—during their mean 7-year disease duration.
Of these infections, 37% were classified as major in that they required hospitalization and intravenous antibiotics. The most common sites of major infections were the lower respiratory tract (33%), systemic infections (19%), and the gastrointestinal tract (12%), said Dr. Bultink, a rheumatologist at Slotervaart Hospital, Amsterdam.
Staphylococcus aureus was identified as the causal organism in 16% of major infections, making it the No. 1 culprit microorganism in severe episodes.
In a multivariate regression analysis, the significant independent risk factors for development of major infections were the presence of IgG anticardiolipin antibodies; leukopenia during the disease course; use of methotrexate at any time in treating SLE; and longer disease duration.
Turning to the 115 infections in the group as a whole, microorganisms were isolated in 50% of cases. The single most common type of infection was herpes zoster skin eruption at 16% of all infections.
Of infections in the SLE patients, 29% involved the skin and/or mucosa, 22% involved the lower respiratory tract, and 14% involved the upper respiratory tract, she said at the meeting sponsored by the European League Against Rheumatism.
Five patients developed opportunistic infections. There were two cases of Candida albicans esophagitis; one of sepsis from cytomegalovirus and C. albicans; one case of sinusitis caused by Aspergillus fumigatus; and a Klebsiella pneumoniae pneumonia.