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

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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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Funding

This project was supported by the grants from the National Natural Science Foundation of China (81601403, 81603435), grants from Natural Science Foundation of Guangdong Province (2018A0303130294), and grants from Guangdong Medical Research Foundation (A2018027).

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Author notes

  1. Minxi Lao and Mingcheng Huang contributed equally to this work.

Authors and Affiliations

  1. Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, No 58, Zhongshan 2nd Road, Guangzhou, 510080, China

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

  2. Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Minxi Lao & Chen Li

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  1. Minxi Lao
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  2. Mingcheng Huang
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Correspondence to Zhongping Zhan or Dongying Chen.

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The International Classification of Diseases-10 coding of vasculitis (DOCX 11 kb)

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Lao, M., Huang, M., Li, C. et al. Infectious profile in inpatients with ANCA-associated vasculitis: a single-center retrospective study from Southern China. Clin Rheumatol 39, 499–507 (2020). https://doi.org/10.1007/s10067-019-04779-9

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  • DOI: https://doi.org/10.1007/s10067-019-04779-9

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