ABSTRACT
Objective To investigate the incidence,pathogens and clinical features of nosocomial infections in patients with ac-tive rheumatoid arthritis (RA).Methods A total of 2 452 active RA patients were reviewed and analyzed retrospectively in Shanghai hospitals between January 2009 and February 2011.The demographic and clinical characteristics were described.Re-sults A total of 721 episodes of infection were found in 503 patients (20.51%).About 40.97% of the infections were of respir-atory tract,22.35% of urinary tract,and 8.58% of skin and soft tissues.Major pathogens were bacteria (623,86.40%),in-cluding E.coli (226,31.35%),P .aeruginosa (40,5.55%),A.baumannii (48,5.42%),Enterococcus (144,16.25%), methicillin-resistant Staphylococcus aureus (15, 2.08%), methicillin-resistant coagulase-negative Staphylococcus (7, 0.97%).The other pathogens included fungi (74,10.26%),herpes zoster (16,2.21%),and Mycobacterium tuberculosis (8,1.10%).Conclusions Nosocomial infection is mainly seen in respiratory and urinary tracts,usually associated with E.co-li,P .aeruginosa,A.baumanii,methicillin-resistant Staphylococcus and Enterococcus .
ABSTRACT
Objective To evaluate the therapeutic effect of etanercept in patients with Behcet's disease (BD). Methods Twenty six patients with active BD were eligible for anti-TNF-α treatment, which failed previously to commonly used drugs. All the patients were stopped previous therapy and treated with etanercept 25 mg twice a week. The clinical responses and laboratory parameters were evaluated at the baseline, week 2, 4, 8, 12 and 24, and week 12 of etanercept withdrawal. Results Etanercept was effective in several clinical lesions and lab. parameters at all time points. Especially at week 2, including oral ulcers, genital ulcers, erythema nodosum, pseudofolliculitis and swollen joints (P<0.01). Two of four cases of uveitis were contro-lled with addition of topical corticosteroids; The ileocecal junction ulcer of 1 patient healed after 2 months etanercept therapy; four cases of epididymitis reached complete remission at week 4. ESR(P=0.012) and CRP (P=0.013) were also rapidly decreased at week 2. Most patients were relapsed at week 12 of etanercept withdrawal compared with baseline except for swollen joints (0.65±1.09 vs 0.31±0.60, P<0.01) after etanercept withdrawal, in which the typical rebound was CRP from (481±312) mg/L to (549±267) mg/L (P=0.013).Conclusion Etanereept has rapid efficacy onset for most of the mucocutaneous disorders and possibly effective for arthritis, ophthalmitis, epididymitis and colonic ulcer of BD.
