Risk factors for hospital-associated infections and distribution of pathogens isolated from hospitalized patients with systemic lupus erythematosus

OBJECTIVE To observe the distribution of pathogens isolated from the systemic lupus erythematosus(SLE) patients with hospital-associated infections(HAIs) and analyze the risk factors for the HAIs so as to provide evidence bases for clinical prevention and treatment. METHODS The clinical data were collected from 186 patients with SLE who were treated in The First Affiliated Hospital of Jinzhou Medical University from Jan. 2021 to Dec. 2024 and were retrospectively analyzed. The enrolled patients were divided into the infection group with 56 cases and the non-infection group with 130 cases according to the status of HAIs. The baseline data, clinical characteristics, clinical laboratory test indexes and distribution of pathogens were observed and compared between the two groups of patients. Multivariate logistic regression analysis was performed for the risk factors for the HAIs in the SLE patients. RESULTS Among the 186 SLE patients, 56 had HAIs, with the infection rate 30.11%. Totally 65 strains of pathogens were isolated, 40(61.54%) of which were gram-positive bacteria, 20(30.77%) were gram-negative bacteria, and 5 (7.69%)were fungi. The proportion of the patients who had respiratory tract infections was highest(46.43%). Multivariate logistic regression analysis indicated that complication with diabetes mellitus(OR=2.354,95%CI:1.032 to 5.372), dosage of hormone no less than 1mg/(kg·d)(OR=3.436,95%CI:1.640 to 7.205), score of SLE disease activity index (SLEDAI) no less than 10 points (OR=2.333,95%CI:1.082 to 5.032) and the serum albumin level less than 30 g/L(OR=2.633,95%CI:1.196 to 5.801) were the risk factors for the HAIs in the SLE patients. CONCLUSIONS The incidence of HAIs is high among the SLE patients, and the gram-negative bacteria are dominant among the pathogens. The complication with diabetes mellitus, large dose of hormones, high SLEDATI and low albumin level are the risk factors for the HAIs. It is necessary for the hospital to take targeted prevention measures.