RT Journal Article
T1 Bacteremia in Systemic Lupus Erythematosus in Patients from a Spanish Registry: Risk Factors, Clinical and Microbiological Characteristics, and Outcomes.
A1 Rua-Figueroa, Iñigo
A1 Lopez-Longo, Francisco J
A1 Del Campo, Victor
A1 Galindo-Izquierdo, Maria
A1 Uriarte, Esther
A1 Torre-Cisneros, Julian
A1 Vela, Paloma
A1 Tomero, Eva
A1 Narvaez, Javier
A1 Olive, Alejandro
A1 Freire, Mercedes
A1 Salgado, Eva
A1 Andreu, Jose Luis
A1 Martinez-Taboada, Victor
A1 Calvo-Alen, Jaime
A1 Hernandez-Cruz, Blanca
A1 Raya, Enrique
A1 Quevedo, Victor
A1 Exposito Perez, Lorena
A1 Fernandez-Nebro, Antonio
A1 Ibañez, Monica
A1 Pascual-Valls, Elia
A1 Rua-Figueroa, David
A1 Naranjo, Antonio
A1 Pego-Reigosa, Jose M
K1 Bacteremia
K1 Infection
K1 Systemic lupus erythematosus
K1 Comorbidity
K1 Dose-response relationship, drug
AB To describe the incidence of bacteremia in a large multicentric cohort of patients with systemic lupus erythematosus (SLE) and their clinical characteristics and to identify risk factors. All bacteremic episodes from the Spanish RELESSER registry were included. Clinical and laboratory characteristics concerning bacteremia and SLE status, as well as comorbidities at the time of infection, were retrospectively collected. A comparison with sex- and age-matched SLE controls without bacteremia was made. A logistic regression was conducted. The study included 114 episodes of bacteremia in 83 patients. The incidence rate was 2.7/1000 patient-years. At the time of bacteremia, the median age was 40.5 (range: 8-90) years, and 88.6% of patients were female. The Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index was 4 [interquartile range (IQR) 8]; 41% had an SLE flare (66% severe); Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was 3 (IQR 4). A comorbidity was recorded in 64% of cases. At the time of bacteremia, 88.6% received corticosteroids (68.6% > 10 mg/day) and 57% immunosuppressors. Gram-negative bacilli, most frequently Escherichia coli (29.8%), caused 52.6% of the episodes. The bacteremia-related mortality was 14% and bacteremia was recurrent in 27.2% of cases. A dose-response relationship was found between corticosteroids and bacteremia risk. In the multivariate analysis, these factors were associated with bacteremia: elevated creatinine (OR 1.31, 95% CI 1.01-1.70; p = 0.045), diabetes (OR 6.01, 95% CI 2.26-15.95; p  10 mg/day) and 57% immunosuppressors. Gram-negative bacilli, most frequently Escherichia coli (29.8%), caused 52.6% of the episodes. The bacteremia-related mortality was 14% and bacteremia was recurrent in 27.2% of cases. A dose-response relationship was found between corticosteroids and bacteremia risk. In the multivariate analysis, these factors were associated with bacteremia: elevated creatinine (OR 1.31, 95% CI 1.01-1.70; p = 0.045), diabetes (OR 6.01, 95% CI 2.26-15.95; p  Bacteremia occurred mostly in patients with active SLE and was frequently associated with severe flares and corticosteroid use. Recurrence and mortality were high. Immunosuppressors, comorbidities, and disease-related damage were associated with bacteremia.
PB Journal of Rheumatology Publishing Co.
SN 0315-162X
YR 2019
FD 2019-03-26
LK http://hdl.handle.net/10668/13838
UL http://hdl.handle.net/10668/13838
LA en
NO Rúa-Figueroa I, López-Longo FJ, Del Campo V, Galindo-Izquierdo M, Uriarte E, Torre-Cisneros J, et al. Bacteremia in Systemic Lupus Erythematosus in Patients from a Spanish Registry: Risk Factors, Clinical and Microbiological Characteristics, and Outcomes. J Rheumatol. 2020 Feb;47(2):234-240
DS RISalud
RD Apr 18, 2025