Azad M A K, Islam M N, Choudhury M R, Haq S A, Shahin A, Rashid F B, Sharmin F
Dr Mohammad Abul Kalam Azad, Assistant Professor, Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2025 Jan;34(1):141-152.
Urinary tract infection (UTI) is one of the important causes of morbidity and mortality in Systemic lupus erythematosus (SLE). To calculate the frequency, organism and risk factors for UTI in SLE. This observational study was conducted in the lupus clinic in the department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2012 to January 2014. Total 169 diagnosed SLE patients were enrolled consecutively. Urinary symptoms positive patients were considered as case and symptoms negative were considered as controlled. The patients having DM, Recurrent UTI and unable to participant were excluded. Urinary symptoms including demographic variable, disease activity index- Systemic Lupus Erythematosus Disease activity index (SLEDAI), organ damage index Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) were evaluated. Dose, duration and cumulative dose of steroid, HCQ, MMF, azathioprine and cyclophosphamide were evaluated for risk factor of UTI. Serum C3, C4, CRP, ANA, anti-ds DNA, CBC, urine routine examination with culture and sensitivity were done. Out of 169 patients 19 patients excluded in this series. Forty patients had UTI and rate of UTI was 28.57%. The most common organism was E coli and it was 52.5%. High disease activity index (SLEDAI), severe organ damage index (SLICC score), Lupus nephritis and cyclophosphamide were found risk factor for UTI by Bi-variate analyses. Use of cyclophosphamide in SLE patient was found as significant risk factor in multivariate analyses. Frequency of UTI in SLE was quiet high. Past suffering from Lupus nephritis and use of Cyclophosphamide were notable risk factor for UTI.
尿路感染（UTI）是系统性红斑狼疮（SLE）发病和死亡的重要原因之一。旨在计算SLE患者UTI的发生率、病原体及危险因素。本观察性研究于2012年9月至2014年1月在孟加拉国达卡班加班杜·谢赫·穆吉布医科大学（BSMMU）风湿病科的狼疮门诊进行。共连续纳入169例确诊的SLE患者。有泌尿系统症状阳性的患者被视为病例，症状阴性的患者被视为对照。排除患有糖尿病、复发性UTI及无法参与的患者。评估了包括人口统计学变量、疾病活动指数——系统性红斑狼疮疾病活动指数（SLEDAI）、器官损害指数——系统性红斑狼疮国际协作诊所/美国风湿病学会（SLICC/ACR）在内的泌尿系统症状。评估了类固醇、羟氯喹、霉酚酸酯、硫唑嘌呤和环磷酰胺的剂量、疗程及累积剂量作为UTI的危险因素。检测了血清C3、C4、CRP、ANA、抗双链DNA、血常规、尿常规及培养和药敏试验。本系列研究中排除了169例患者中的19例。40例患者发生UTI，UTI发生率为28.57%。最常见的病原体是大肠杆菌，占52.5%。通过双变量分析发现高疾病活动指数（SLEDAI）、严重器官损害指数（SLICC评分）、狼疮性肾炎和环磷酰胺是UTI的危险因素。在多变量分析中发现SLE患者使用环磷酰胺是显著的危险因素。SLE患者UTI的发生率相当高。既往患有狼疮性肾炎和使用环磷酰胺是UTI显著的危险因素。
