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Clinical Rheumatology

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01-02-2020 | ANCA-Associated Vasculitis | Original Article

Infectious profile in inpatients with ANCA-associated vasculitis: a single-center retrospective study from Southern China

Authors: Minxi Lao, Mingcheng Huang, Chen Li, Hao Li, Qian Qiu, Zhongping Zhan, Dongying Chen

Published in: Clinical Rheumatology | Issue 2/2020

Abstract

Objectives

Infection is a common complication in ANCA-associated vasculitis (AAV). The study goal was to investigate the infectious profile in patients with AAV from Southern China.

Methods

A retrospective study was performed on the inpatients from the First Affiliated Hospital of Sun Yat-sen University from 2012 to 2017. Demographic and clinical characteristics were recorded.

Results

A total of 132 AAV inpatients with 174 episodes of infection (prevalence, 63.8%) were included. Lung was the most commonly involved. Ninety-six (72.7%) patients developed infection during the first 6 months after AAV diagnosis. Bacteria (75.9%) were the prominent microbes. Gram-negative bacteria were predominant (71.4%). The most frequently isolated bacteria were P. aeruginosa (16.7%) and A. baumannii (16.7%). Mixed infection accounted for 14.9% of the episodes, while fungal infection accounted for 6.3%. Mortality rate was 12.9% (17/132). Six deceased patients (46.2%) were infected with multiple pathogens. In multivariate analysis, smoking (odds ratio (OR) 2.38, 95% confidence interval (CI) 1.13–5.03, P = 0.02), kidney involvement (OR 2.56, 95% CI 1.11–5.88, P = 0.03), lymphopenia (OR 2.33, 95% CI 1.20–4.55, P = 0.01), and dialysis (OR 3.06, 95% CI 1.14–8.20, P = 0.03) were associated with infection in patients with AAV.

Conclusions

Bacteria, especially Gram-negative bacteria, were the major pathogens in Chinese AAV patients. Mixed infection was a great threat to death. Infection tended to develop within the 6 months after AAV diagnosis. Smoking, kidney involvement, dialysis, and lymphopenia increased the risk of infection in patients with AAV.

Key Points
• Infection tended to develop within the 6 months after AAV diagnosis.
• Gram-negative bacteria were the leading pathogens.
• Smoking, kidney involvement, dialysis, and lymphopenia increased the risk of infection in patients with AAV.

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Title: Infectious profile in inpatients with ANCA-associated vasculitis: a single-center retrospective study from Southern China
Authors: Minxi Lao
Mingcheng Huang
Chen Li
Hao Li
Qian Qiu
Zhongping Zhan
Dongying Chen
Publication date: 01-02-2020
Publisher: Springer London
Keywords: ANCA-Associated Vasculitis
ANCA-Associated Vasculitis
Bronchiectasis
Glucocorticoid
Lymphopenia
Published in: Clinical Rheumatology / Issue 2/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04779-9

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