Background Infection is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). The spectrum of infectious agents in SLE patients varies significantly among different ethnic groups. The national surveillance study from the China showed that Gram-negative bacteria (GNB) was the most the common bacterial infection in China, while Gram-positive bacteria (GPB) was predominant in European countries.
Objectives To identify the spectrum and drug resistant pattern of infection caused by GNB in patients hospitalized with SLE.
Methods The clinical and microbiological data from hospitalized SLE patients with bacterial infection between June 2005 and June 2015 was collected and then analyzed retrospectively.
Results Two hundred and sixty-eight episodes of bacteria had been identified from 3815 hospitalized patients. 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 (66/178, 37.1%) was the most common isolate, followed by Acinetobacter baumannii (36/178, 20.2%), Klebsiella pneumoniae (24/178, 13.5%), Pseudomonas aeruginosa (20/178, 11.2%), Haemophilus influenzae (10/178,5.6%), Salmonella sp. (7/178, 3.9%), Enterobacter aerogenes (5/178, 2.8%), Stenotrophomonas maltophilia (5/178, 2.8%), Citrobacter freundii (3/178,1.7%), Proteus mirabilis (2/178,1.1%). Resistant isolates (53/178, 30.0%) were more common documented in GNB, mostly extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (30/66, 45.5%) and Klebsiella pneumonia (6/24, 25%), and multi-drug resistant acinetobacter baumannii (36.1%). Susceptibility tests showed that the ESBL-producing strains were highly sensitive to carbapenems, β-lactamase inhibitor compound families, and certain cefalosporin (Cefepime and Ceftazidime) in vitro. (the resistance rate <20%), whereas it was highly resistant to ampicillin and Gentamicin. Besides carbapenems and Cefoperazone/sulbactam, Acinetobacter baumannii was resistant to most antibiotics.
Conclusions GNB was predominant in Chinese hospitalized patients with SLE. The drug resistance of GNB has increased significantly. It was necessary to rational use of antibiotics in patients with SLE.
Disclosure of Interest None declared