Background Infections are frequent cause of death in lupus patients because of disease depending mechanisms and immunosupressive treatment. Kidneys are often involved in course of lupus. We found asymptomatic bacteriuria in 16,5% women with SLE in first year of our study but longer 5 years observation could help us to understand its clinical importance.

Objectives

1. Estimation of incidence of asymptomatic bacteriuria (a.b.) in population of women with SLE in 5 years observation.

2. Examination of asymptomatic bacteriuria maintaince in following years of observation.

3. Evaluation of incidence of symptomatic pyelonephritis in SLE women with a.b.

4. Evaluation of need of antibacterial treatment in SLE patients with a.b.

Methods 85 women aged 24–77(mean 45,2) years with mean SLE duration 10,2 years (2–33) were examined for 5 years. All of them were fulfilling ARA criteria for diagnosis of SLE. We did bacteriological analysis of SLE women urina 5 times in the 5 following years. Patients wereobserved clinically and parameters of biochemical and immunologicalactivity were done. Among group with a.b. were countedwomen whohadsignificant bacteriuria higher than 10⁴ in ml urina. Wewere analysing type of bacteria and antibiotic resistancy.

Results In the following 5 years of observation asymptomatic bacteriuria was found with incidence from 12,8% to 22,5% (mean 17,6%). From 60% to 80% patients with a.b.(mean 70%) eliminated bacteria from urina in period one year without antibacterial treatment. In other patients mean 30% in second urina cultures which was done 1 year after first with a.b., significant bacteriuria was persistent. 50% of women with persistent bacteriuria after one year had in urina the same type of bacteria but in 50% patients type of bacteria was changed. In 5 years only 3 incidence of symptomatic pyelonephritis in SLE women with a.b. was observed. In all 3 cases nephrolithiasis was coexisted with SLE.

Conclusion

1. Incidence of asymptomatic bacteriuria in women with SLE was 17,6%.

2. 70% patients with a.b. eliminated bacteriuria without antibacterial treatment in one year.

3. In patients with a.b. in course of SLE symptomatic pyelonephritis was no observed (besides patients with nephrolithiasis).

4. Asymptomatic bacteriuria in women with SLE do not need antibacterial treatment.