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Asociación de actividad lúpica y el riesgo de infección nosocomial en pacientes de un Hospital universitario en Medellín: estudio prospectivo 2001-2004

Keywords: lupica activity, nosocomial infection, sledai, les.

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Abstract:

background: systemic lupus erythematosus (sle) patients have higher rates of morbility and mortality than general population because of inflammatory activity and high infections frequencies. the infections have been associated with activity index of the disease and the use of immunosuppressant drugs. objective: to determine the factors associated with nosocomial infections in sle patients who required in hospital treatment. methods: we performed a prospective study of sle patients who met the acr criteria and who were hospitalized between january 2001 and december 2004. exclusion criteria were community acquired infections, onset of infections in the first 48 hours of hospitalization, hiv and patients with neoplasm. the sle activity was quantified with the sledai index and infection was defined according to microorganism isolated or cdc criteria for those without an isolated microorganism. we studied this variables: age, sex, time from onset of sle, hospital stay, use of immunosuppressant drugs, type of infection, and cause of death. results: one hundred and twenty three patients were included who had 155 hospital admissions, 106 were women (82.2%). mean age was 27.7 +/- 12.6 years (7-73) with a mean time from diagnostic of 27.8 +/- 49.4 months (0-300), 56 patients (45.5%) had novo diagnosis, 25 patients had chronic renal insufficiency including 10 in hemodialysis. respect of previous treatment, 58 (47.1%) patients did not have received steroids, 36 (29.3%) have been receiving 20 mg of prednisone or less, and 29 (23.6%) more than 20 mg of prednisone, 31 (25.2%) patients pulses of ciclophosphamide and 13 others immunosuppressant drugs. the sledai median and mean were 14 (iqr 7-20) and 14.7 +/- 9.9 respectively. nosocomial infection was reported in 38 (30.9%), 31 patients just one episode of infection and 13 more than one, with a total of 69 events. in univariate analysis was noted that these factors were associated with nosocomial infections: de novo diagnosis, longe

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