Bacteremia in female Chinese patients with systemic lupus erythematosus: a case-control study

Abstract

Introduction: Bacteremia is a common complication in systemic lupus erythematosus (SLE) patients, causing high morbidity and mortality. We investigated characteristics, pathogens, and sites of infection using a cohort of 64 female adults from a single university hospital in China. Methodology: SLE patients who had at least one episode of bacteremia (n = 16) were compared with non-bacteremia SLE patients (n = 48) in a case-control fashion, matching for age at SLE diagnosis and time of admission. Demographic characteristics, clinical and laboratory data, and bacteriologic examinations were collected and reviewed. Results: A series of parameters were found to be significantly different between controls and cases at bacteremia diagnosis, including an SLE disease activity index, multiple major organ involvement (> 2), active renal disease, leukocytes, neutrophils, 24-hour urine protein, erythrocyte sedimentation rate (ESR), aspartate aminotransferase (AST), creatinine, hemoglobin, lymphocyte, platelets, and albumin. Eighteen episodes of bacteremia were analyzed, with Escherichia coli and Staphylococcus aureus being the most frequent isolates. Additionally, Listeria monocytogenes, Rhodotorula mucilaginosa, and Salmonella choleraesuis, which were very rare in the general population, were isolated from the bloodstreams of the cases. Apart from bacteremia without focus, respiratory tract, gastrointestinal tract, urinary tract, skin, and soft tissue were the major origins of infection. Conclusions: The present study depicts the nature of a cohort of female Chinese SLE patients with bacteremia, revealing that bacteremia is a critical factor contributing to the aggravation of SLE. Our findings provide useful information regarding the control and prevention of bacteremia in female SLE patients in China.