Teh CL, et al. - Authors ascertained the pattern of serious infections in patients with systemic lupus erythematosus (SLE). They also identified the predictors of infection-related mortality among these patients with serious infections. The predominant pattern of infection in this SLE cohort were pneumonia and Gram-negative organisms. The independent prognostic predictors of infection-related mortality were the presence of flare of SLE and bacteremia, whereas, among SLE patients with serious infections, hydroxychloroquine was protective of infection-related mortality.

Methods

• Experts prospectively studied all SLE patients who were hospitalized with infections in Sarawak General Hospital during 2011–2015.
• They collected the demographic data, clinical features, and outcomes.
• To determine the independent predictors of infection-related mortality, Cox regression analysis was carried out .

Results

• As per data, there were a total of 125 patients with 187 episodes of serious infections.
• Findings suggested the patients to be of multiethnic origins with female predominance (89.6%).
• The mean age was noted to be 33.4 ± 14.2 years.
• The mean disease duration in patients was 66.8 ± 74.0 months.
• Pulmonary (37.9%) was the most common site of infection, followed by septicemia (22.5%).
• Within the cohort, gram-negative organisms (38.2%) were the predominant isolates.
• Researchers noted 21 deaths (11.2%) during the study period.
• Flare of SLE (HR 3.98, CI 1.30–12.21) and the presence of bacteremia (HR 2.54, CI 0.98–6.59) were the independent predictors of infection-related mortality among this cohort of SLE patients.
• The protective of mortality from serious infections (HR 9.26, CI 3.40–25.64) was hydroxychloroquine.
• Results demonstrated that the pneumonia and Gram-negative organisms were the predominant pattern of infection in this SLE cohort.