Background In recent decades, the leading cause of death in patients with systemic lupus erythematosus (SLE) has changed from active disease to infection. The spectrum of infectious agents in SLE patients varies significantly among different ethnic groups. Furthermore, multiple drug resistance (MDR) pathogens have become the biggest concern worldwide, and the situation is even more serious in China.
Objectives To investigate the spectrum and antibiotic resistant pattern of bacterial infection in patients hospitalized with SLE.
Methods We collected the clinical and microbiological data from hospitalized SLE patients with bacterial infection between June 2005 and June 2015 and then conducted retrospective analyses.
Results Among our sample of 3815 hospitalized patients, 258 episodes had microbiological defined bacterial infection. In terms of isolated microorganisms, gram-negative bacteria (GNB) were predominant over gram-positive bacteria (GPB) (178 isolates vs. 90 isolates). In the GNB, Escherichia coli (24.6%) was the most common isolate, followed by Acinetobacter baumannii (13.4%) and Klebsiella pneumoniae (9.0%). For GPB, coagulase negative Staphylococcus (CNS, 13.4%) was most commonly documented followed by Staphylococcus aureus (11.2%) and other GPB. Overall, MDR bacteria were detected in 26.9% of the isolates. Extended-spectrum beta-lactamase (ESBL) producers were expressed mainly in Escherichia coli (30/66, 45.5%) and Klebsiella pneumoniae (7/24, 29.2%). The proportion of multi-drug resistant acinetobacter baumannii (MDR-AB) in the sample was 36.1%. Eight of Staphylococcus aureus (8/30, 26.7%) were found to be methicillin-resistant Staphylococcus aureus (MRSA), and fourteen of CNS (14/36, 38.9%) were considered methicillin-resistant CNS (MRSCNS).
Conclusions Predominance of GNB with emerging of MDR isolates was the notable features of bacterial infection in Chinese SLE patients. Therefore rational use of antibiotic will be urgently needed to reduce the morbidity and mortality of patients with SLE.
Disclosure of Interest None declared
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