Characteristics and Risk Factors of Infections among Patients with Autoimmune Bullous Diseases: A Retrospective Single-Center Study in China  

作　　者：Feiran Zhou Xiaoping Zheng Yixuan Yang Qingluan Yang Jingyu Zhou Haoxin Xu Xiaoqun Luo Lingyun Shao Wenhong Zhang Zhonghua Li Qiaoling Ruan 

机构地区：[1]Department of Infectious Diseases,Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response,National Medical Center for Infectious Diseases,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai 200040,China [2]Pingyang Hospital,Wenzhou Medical University,Wenzhou,Zhejiang province 325400,China [3]Department of Dermatology,Huashan Hospital affiliated to Fudan University,Shanghai 200040,China [4]Department of Allergy&Immunology,Huashan Hospital affiliated to Fudan University,Shanghai 200040,China [5]Shanghai Huashen Institute of Microbes and Infections,Shanghai 200052,China [6]Taicang First People’s Hospital,Suzhou,Jiangsu province 215400,China

出　　处：《Infectious Diseases & Immunity》2024年第4期170-177,共8页感染性疾病与免疫（英文）

基　　金：supported by National Natural Science Foundation of China(82271794 and 82302533);Shanghai Science and Technology Commission sailing project(22YF1404900).

摘　　要：Background: Since infections can lead to adverse outcomes in autoimmune bullous diseases (AIBD), this study aimed to analyze infection characteristics in AIBD, predict infection risk factors and provide probable suggestions to infection prevention, which will spot a light on early discovery and prevention of infections in AIBD patients. Methods: This is a retrospective study of the medical records of inpatients diagnosed with AIBD at the Department of Infectious Diseases and Dermatology, Huashan Hospital from January 2017 to December 2021. We collected patients’ clinical manifestations and laboratory examination results. Risk factors for infections were evaluated using multivariate logistic regression. Results: A total of 263 AIBD patients were included in the study. The overall incidence of infection was 42.2% (111/263). Pemphigus had a higher infection rate (74/142, 52.1%) than bullous pemphigoid (37/121, 30.6%). Among the patients with infections, 49.5% (55/111) had bacterial infections, 13.5% (15/111) had fungal infections, 2.7% (3/111) had virus infections, and 34.2% (38/111) had mixed infections. Staphylococcus aureus and Candida were the most common pathogens in localized infections, while Cryptococcus and Candida were predominant in systemic infections. In the multivariate logistic model, pemphigus (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.41-4.63), hypoalbuminemia (OR = 3.78, 95% CI 1.68-8.50), and systemic glucocorticoid treatment (OR = 4.67, 95% CI 2.51-8.68) were independent risk factors for infection in AIBD patients. Bullous pemphigoid (OR = 3.99, 95% CI 1.03-15.45), high-dose (average > 24 mg/day) compared to low-dose (average ≤ 6 mg/day) and medium-dose (average 6-24 mg/day) systemic glucocorticoid treatment (OR = 19.31, 95% CI 3.32-112.28, and OR = 5.71, 95% CI 1.37-23.79) were associated with increased risk factors of systemic infection in AIBD patients with systemic glucocorticoid treatment. A methylprednisolone dose averaging 14 mg/day over the past three months had a 75.0% p

关 键 词：PEMPHIGUS Bullous pemphigoid GLUCOCORTICOIDS INFECTIONS Retrospective studies 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]