Characteristics And Risk Factors Of Systemic Lupus Erythematosus Complicated With Urinary Tract Infection

Objective: To understand the clinical characteristics of SLE complicated with urinary tract infection,and to explore the main risk factors of SLE complicated with urinary tract infection,so as to provide reference for clinicians to prevent,diagnose and treat such diseases.Methods: Eighty SLE patients with urinary tract infections admitted to the Department of Rheumatology and Immunology of the First Affiliated Hospital of Bengbu Medical College from January 2013 to May 2018 were selected as the infection group.At the same time,80 SLE patients with urinary tract infections excluded from the same period of hospitalization were selected as the control group according to admission time,sex,age and course of disease.The general data and laboratory indicators of SLE patients were collected and analyzed retrospectively.The data of the two groups were compared and analyzed by t-test,chi-square test and binary classification logistic regression analysis.Results: The SLEDAI score,hospitalization days,CRP level,ESR level,urinary protein positive cases,urinary sediment leukocyte count and urinary sediment bacteria count in the infected group were significantly higher than those in the control group(P < 0.01),and the difference was statistically significant.The duration of disease < 1year,hospitalization time > 3 weeks and Ig M in the infected group were significantly higher than those in the control group(P < 0.05).There was no significant difference in age and course between the infected group and the control group;There was no significant difference in Ig G,Ig A,C3,C4,WBC count,creatinine and urea nitrogen between the infected group and the control group(P > 0.05).There was significant difference in the use of prednisone in large doses before admission between the infected group and the control group(dosage > 20 mg/d,duration > 1 month),but there was no significant difference in the use of immunosuppressive agents between the two groups.Logistic single factor analysis showed that CRP,ESR,urinary sediment bacterial count,Ig M,hospitalization days,SLEDAI score were correlated with SLE combined with urinary tract infection(P < 0.05);Logistic single factor analysis showed that there were significant differences between the two groups in six indicators into unconditional Logistic regression model for multivariate analysis,the results were significant.The results showed that hospitalization days,SLEDAI score and urinary sediment bacterial count were independent risk factors for SLE complicated with urinary tract infection(P < 0.05).Among 80 pathogenic bacteria isolated from urine culture of infected group,66 were Escherichia coli,accounting for82.5%,which was the most common.Drug susceptibility test showed that 31 of 80 pathogenic bacteria were resistant to levofloxacin,the drug resistance rate was38.75%.Among 80 patients with urinary tract infection,11 patients showed asymptomatic bacteriuria,accounting for 13.75% of the total urinary tract infection.In this study,33 of the 80 patients were treated with both ordinary urine culture and L-type urine culture,accounting for 41.25%.Of the 80 patients,29 were negative in general urine culture and 36.25% were positive in L-type urine culture.Conclusion: Escherichia coli is the most common pathogen of SLE combined with urinary tract infection.Conventional levofloxacin is effective in the treatment of infection,and some pathogens have drug resistance.Some patients with urinary tract infections have no irritation sign.The detection rate of urinary tract infections can be improved by using common culture and L-type culture at the same time.Long hospitalization time,high SLEDAI score and abnormal urinary sediment bacterial count are independent risk factors for urinary tract infection in SLE patients.It is possible to reduce the incidence of urinary tract infection in SLE patients by shortening hospitalization time and controlling disease activity in time.