Infections are one of the leading causes of
morbidity and
mortality in
patients with
systemic lupus erythematosus [SLE],
therapeutic,
dose-related and genetic factors all contribute to a lupus
patient's increased susceptibility to
infections. Although bacterial pathogens are the most common cause of
infections, a wide variety of pathogens have been reported. Multiple
risk factors for
infection in SLE have been reported. These include
disease activity, renal
disease, gluco-
corticoid use and cytotoxic
therapies. The objective was to analyze
infection risk factors in Egyptian lupus
patients; the influence of these factors on
disease activity, organ damage,
disease development and the type of micro-organisms involved. The study included forty
patients with SLE [37
females and 3
males] They were selected from those attending the SLE clinic in Ain Shams
University hospital outpatient. Lupus
disease activity had been established according to SLAM score. They were subjected to a
retrospective study to Complete medical
history with special interest on duration of the
disease, current
treatment for lupus and
dosage of
prednisone,
antimalarial drugs and
immunosuppressive agents, number of
infections whatever the cause during One year and number of admission due to episodes of
infection whatever the cause. It included also symptoms of
urinary tract infection [UTI]
upper respiratory tract infection [URTT] as well as any complaint of the
patient proved to be due to
infection Laboratory assays included CBC, ESR,
serum creatinine,
urine analysis, 24 hours
protein in
urine and
culture when necessary. Increased
incidence of
infection in lupus
patients which was 83
infections during the one year study. the
incidence of
Upper Respiratory Tract Infections was 8
infections [9.64%],
Urinary Tract Infections 70
infections [84.34%], and
Skin Infections 5
infections [6.02%] 83% of the
cultures had had obtained from lupus
patients. 83% of the
urine were G- ve organisms. E. coli was the most common uropathogen encountered in this study [47%] which was resistant to most
antibiotics but was sensitive to
aminoglycosides.
Skin infections were presented by
abscesses 4 times [80%] -with predominance of staphylococci- and
Herpes Zoster once [20%] There was a significant increase in the number of
infection in relation to
corticosteroids dose. There was a statistical significance between
incidence of
infection and addition of immunosupressive
drugs to
corticosteroids. There was a strong relation between
incidence of
infection and
disease activity. SLE itself, increased
dose of
corticosteroids, use of immunosuppressive
drugs and activity of the
disease all are
risk factors in
incidence of
infection in
patients with SLE. UTI followed by URTI and
skin infections including HZ were the most frequent
infections in Egyptian SLE
patients