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Incidence rate and causes of infection in T hai systemic sclerosis patients
Author(s) -
Foocharoen Chingching,
Siriphan Yada,
Mahakkanukrauh Ajanee,
Suwannaroj Siraphop,
Nanagara Ratanavadee
Publication year - 2012
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2012.01728.x
Subject(s) - medicine , incidence (geometry) , progressive systemic sclerosis , multiple sclerosis , intensive care medicine , immunology , raynaud disease , physics , optics
Background Infection is a common cause of death in systemic sclerosis ( SS c) but despite immunosuppressant therapy, there are few reports of opportunistic infection. Objectives To estimate the incidence of infection, to determine the etiologic organism, and to assess the risk factors for infection among T hai SS c patients. Methods A historical cohort analysis was conducted on patients over 15 years of age, diagnosed with SS c, who attended the S cleroderma C linic at S rinagarind H ospital, K hon K aen, T hailand, between J anuary 1, 2005 and D ecember 31, 2006. Results The medical records of 117 SS c patients were reviewed. The female‐to‐male ratio was 1.5 : 1.0. Of the total 310 person‐years under observation, 63 events of infection occurred. The incidence rate of infection was 20.3 per 100 person‐years (95% CI 15.6–26.0) and the incidence rate of major infection was 11.0 per 100 person‐years (95% CI 8.4–16.5). The mean age and mean duration of SS c at the time of infection was 50.1 ± 11.1 years (range, 25.2–76.6) and 12.9 ± 10.4 months (range, 0.5–34.6), respectively. Urinary tract infection was the most common infection (23.8%). Opportunistic infection was found in one case (esophageal candidiasis). Esophageal dysmotility was significantly related to major infection (odds ratio [ OR ] 3.22). There was a clinical association between aspiration pneumonia and esophageal dysmotility ( OR 1.23), as well as non‐strongyloidiasis diarrhea and gastrointestinal involvement ( OR 2.28). One person died due to severe bacterial aspiration pneumonia. Conclusions Infection is not uncommon among SS c patients; however, opportunistic infection is rare, despite immunosuppressant therapy. Esophageal dysmotility increases the risk of major infection, particularly of aspiration pneumonia.