Udayakumar Prabhu D, Chandran Arun K, Crowson Cynthia S, Warrington Kenneth J, Matteson Eric L
From the Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.P.D. Udayakumar, MD; A.K. Chandran, MBBS; C.S. Crowson, MS; K.J. Warrington, MD; E.L. Matteson, MD, MPH, Division of Rheumatology, Mayo Clinic College of Medicine.
J Rheumatol. 2014 Dec;41(12):2447-51. doi: 10.3899/jrheum.140124. Epub 2014 Oct 15.
To assess the occurrence of infections requiring or acquired during hospitalization in patients with giant cell arteritis (GCA).
We retrospectively reviewed a population-based incidence cohort of patients with GCA diagnosed between 1950 and 2009 and compared this cohort with a non-GCA one matched for age, sex, and calendar year from the same population.
We identified 245 patients in the GCA cohort and 245 patients in the non-GCA cohort. Seventy-four GCA subjects (134 episodes) and 79 non-GCA (153 episodes) had infections requiring or acquired during hospitalization [rate ratio (RR) 0.94; 95% CI 0.74, 1.18]. Sixty-seven subjects (107 episodes) in the GCA cohort and 63 subjects (110 episodes) in non-GCA cohort required hospitalization secondary to an infection (RR 1.04; CI 0.80, 1.36). Pneumonia, urinary tract infections (UTI), skin and soft tissue infections accounted for the majority of infections requiring hospitalization and had similar occurrence in both cohorts. UTI accounted for the majority of infections requiring hospitalization in the first 6 months after GCA incidence (RR 3.93; CI 0.85, 56.52). No difference between the 2 cohorts was noted in overall infections acquired during hospitalization (RR 0.68; CI 0.41, 1.08).
There is no overall increased risk of infections requiring or acquired during hospitalization in patients with GCA who are taking glucocorticoid therapy. There may be an increased risk of infections requiring hospitalization, especially of the urinary tract, in the first 6 months after GCA incidence, although this did not achieve statistical significance in our study.
评估巨细胞动脉炎（GCA）患者住院期间发生的需要治疗或获得性感染情况。
我们回顾性分析了1950年至2009年间确诊的以人群为基础的GCA发病率队列，并将该队列与来自同一人群的年龄、性别和历年相匹配的非GCA队列进行比较。
我们在GCA队列中确定了245例患者，在非GCA队列中确定了245例患者。74例GCA患者（134次发作）和79例非GCA患者（153次发作）在住院期间发生了需要治疗或获得性感染[率比（RR）0.94；95%置信区间（CI）0.74，1.18]。GCA队列中的67例患者（107次发作）和非GCA队列中的63例患者（110次发作）因感染需要住院治疗（RR 1.04；CI 0.80，1.36）。肺炎、尿路感染（UTI）、皮肤和软组织感染占需要住院治疗的感染的大多数，且在两个队列中的发生率相似。UTI占GCA发病后头6个月内需要住院治疗的感染的大多数（RR 3.93；CI 0.85，56.52）。在住院期间获得的总体感染方面，两个队列之间未发现差异（RR 0.68；CI 0.41，1.08）。
接受糖皮质激素治疗的GCA患者住院期间发生需要治疗或获得性感染的总体风险没有增加。在GCA发病后的头6个月内，因感染需要住院治疗的风险可能会增加，尤其是尿路感染，尽管在我们的研究中这没有达到统计学显著性。
