Infection in systemic lupus erythematosus.

BACKGROUND

Infections are common in patients with systemic lupus erythematosus (SLE) throughout the course of their disease and remain a source of mortality. The aim of this study was to determine the prevalence of infections, to describe their nature, and analyze their risk factors in adults with SLE.

PATIENTS AND METHODS

We performed a descriptive study, at the Farhat-Hached Hospital in Sousse, and retrospectively analyzed the charts of 75 patients with SLE seen between 1990 and 2004. The group of patients with documented infections was compared to a control group. A logistic regression analysis was performed to determine risk factors associated with infection.

RESULTS

Our study included 64 women and 11 men (median age of 31.4 years). Forty-three patients (57.5%) had 82 infectious episodes: 23 patients had at least two infectious episodes. Most infections were community acquired, and 80% were severe. The most common infections involved the urinary tract (28%), the skin and soft tissue (26.8%), and the respiratory tract (18.3%). Documented pathogens were: 45 common bacteria, 11 Candida albicans and four Mycobacterium tuberculosis. Localized herpes zoster was noted in three cases. Factors associated with infection, found in univariate analysis, were renal involvement, serum albumin lower than 25 g/l, and corticosteroids treatment. Only corticosteroids therapy remained statistically significant after multivariate analysis.