Profile of opportunistic infections among patients on immunosuppressive medication

Srinivas Reddy, Ajay Wanchu, Vaishali Gupta, Pradeep Bambery

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The widespread use of immunosuppressives in treating systemic autoimmune disorders has resulted in opportunistic infections (OIs) following such therapy. Current data regarding the possibility of infection due to these drugs or from the primary disease, per se, is conflicting. Objectives: We aimed to analyse the profile of patients requiring hospitalization for OIs among those being treated with glucocorticoids and other immunosuppressive agents as part of management of systemic autoimmune disorders and to analyse the host factors in relation to OIs. Method: In this descriptive analysis, all patients hospitalized the Postgraduate Institute of Medical Education and Research, Chandigarh, India, under medicinal units for OIs that occurred following and during treatment with corticosteroids and other immunosuppressive agents for treatment of systemic autoimmune disorders from February 2002 to January 2003, were studied. All hospitalized patients received antibiotics according to the nature of infection and sensitivity reports. All relevant clinical details were recorded in a standard pro forma. Descriptive statistics were used. The Institute Ethics Committee's permission was secured prior to study commencement. Results: Nineteen patients (16 female) were admitted because of OIs. Their mean age (± SD) was 37.32 (± 19.9) years. Ten patients had systemic lupus erythematosus (SLE), two had SLE with overlap, five had rheumatoid arthritis, and one each had vasculitis and scleroderma with polymyositis. There were 28 infections. One (5.3%) patient had four infections, one (5.3%) had three, six (31.6%) had two, nine (47.4%) had one, and in two (10.5%) patients the infection was not localized. Of the 19 cases, 10 (52.6%) received > 10 mg of prednisolone each day (median = 1130 mg). The remaining nine (47.4%) were on <10 mg prednisolone each day (median = 880 mg). Methylprednisolone was given to two (6.3%) patients. Bacteria accounted for most of the infections. There were two fungal infections and one patient each with tuberculosis and peritonitis. Infections occurred predominantly in the chest, urine and skin. Septicemia was diagnosed in three patients. There were two deaths, one each with SLE and rheumatoid arthritis. Conclusion: Since infections can occur at low doses of corticosteroids, we suggest that these disorders may be, per se, responsible for an increased risk of infection.

Original languageEnglish (US)
Pages (from-to)269-274
Number of pages6
JournalAPLAR Journal of Rheumatology
Volume9
Issue number3
DOIs
StatePublished - Sep 2006
Externally publishedYes

Fingerprint

Opportunistic Infections
Immunosuppressive Agents
Infection
Systemic Lupus Erythematosus
Prednisolone
Rheumatoid Arthritis
Adrenal Cortex Hormones
Polymyositis
Ethics Committees
Mycoses
Methylprednisolone
Vasculitis
Medical Education
Peritonitis
Glucocorticoids
Statistical Factor Analysis
Biomedical Research
India
Sepsis
Tuberculosis

Keywords

  • Corticosteroids
  • Immunosuppressives
  • Opportunistic infections

ASJC Scopus subject areas

  • Rheumatology

Cite this

Profile of opportunistic infections among patients on immunosuppressive medication. / Reddy, Srinivas; Wanchu, Ajay; Gupta, Vaishali; Bambery, Pradeep.

In: APLAR Journal of Rheumatology, Vol. 9, No. 3, 09.2006, p. 269-274.

Research output: Contribution to journalArticle

Reddy, Srinivas ; Wanchu, Ajay ; Gupta, Vaishali ; Bambery, Pradeep. / Profile of opportunistic infections among patients on immunosuppressive medication. In: APLAR Journal of Rheumatology. 2006 ; Vol. 9, No. 3. pp. 269-274.
@article{911840911e1742ebaf6f7125587e5194,
title = "Profile of opportunistic infections among patients on immunosuppressive medication",
abstract = "Background: The widespread use of immunosuppressives in treating systemic autoimmune disorders has resulted in opportunistic infections (OIs) following such therapy. Current data regarding the possibility of infection due to these drugs or from the primary disease, per se, is conflicting. Objectives: We aimed to analyse the profile of patients requiring hospitalization for OIs among those being treated with glucocorticoids and other immunosuppressive agents as part of management of systemic autoimmune disorders and to analyse the host factors in relation to OIs. Method: In this descriptive analysis, all patients hospitalized the Postgraduate Institute of Medical Education and Research, Chandigarh, India, under medicinal units for OIs that occurred following and during treatment with corticosteroids and other immunosuppressive agents for treatment of systemic autoimmune disorders from February 2002 to January 2003, were studied. All hospitalized patients received antibiotics according to the nature of infection and sensitivity reports. All relevant clinical details were recorded in a standard pro forma. Descriptive statistics were used. The Institute Ethics Committee's permission was secured prior to study commencement. Results: Nineteen patients (16 female) were admitted because of OIs. Their mean age (± SD) was 37.32 (± 19.9) years. Ten patients had systemic lupus erythematosus (SLE), two had SLE with overlap, five had rheumatoid arthritis, and one each had vasculitis and scleroderma with polymyositis. There were 28 infections. One (5.3{\%}) patient had four infections, one (5.3{\%}) had three, six (31.6{\%}) had two, nine (47.4{\%}) had one, and in two (10.5{\%}) patients the infection was not localized. Of the 19 cases, 10 (52.6{\%}) received > 10 mg of prednisolone each day (median = 1130 mg). The remaining nine (47.4{\%}) were on <10 mg prednisolone each day (median = 880 mg). Methylprednisolone was given to two (6.3{\%}) patients. Bacteria accounted for most of the infections. There were two fungal infections and one patient each with tuberculosis and peritonitis. Infections occurred predominantly in the chest, urine and skin. Septicemia was diagnosed in three patients. There were two deaths, one each with SLE and rheumatoid arthritis. Conclusion: Since infections can occur at low doses of corticosteroids, we suggest that these disorders may be, per se, responsible for an increased risk of infection.",
keywords = "Corticosteroids, Immunosuppressives, Opportunistic infections",
author = "Srinivas Reddy and Ajay Wanchu and Vaishali Gupta and Pradeep Bambery",
year = "2006",
month = "9",
doi = "10.1111/j.1479-8077.2006.00212.x",
language = "English (US)",
volume = "9",
pages = "269--274",
journal = "International Journal of Rheumatic Diseases",
issn = "1756-1841",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Profile of opportunistic infections among patients on immunosuppressive medication

AU - Reddy, Srinivas

AU - Wanchu, Ajay

AU - Gupta, Vaishali

AU - Bambery, Pradeep

PY - 2006/9

Y1 - 2006/9

N2 - Background: The widespread use of immunosuppressives in treating systemic autoimmune disorders has resulted in opportunistic infections (OIs) following such therapy. Current data regarding the possibility of infection due to these drugs or from the primary disease, per se, is conflicting. Objectives: We aimed to analyse the profile of patients requiring hospitalization for OIs among those being treated with glucocorticoids and other immunosuppressive agents as part of management of systemic autoimmune disorders and to analyse the host factors in relation to OIs. Method: In this descriptive analysis, all patients hospitalized the Postgraduate Institute of Medical Education and Research, Chandigarh, India, under medicinal units for OIs that occurred following and during treatment with corticosteroids and other immunosuppressive agents for treatment of systemic autoimmune disorders from February 2002 to January 2003, were studied. All hospitalized patients received antibiotics according to the nature of infection and sensitivity reports. All relevant clinical details were recorded in a standard pro forma. Descriptive statistics were used. The Institute Ethics Committee's permission was secured prior to study commencement. Results: Nineteen patients (16 female) were admitted because of OIs. Their mean age (± SD) was 37.32 (± 19.9) years. Ten patients had systemic lupus erythematosus (SLE), two had SLE with overlap, five had rheumatoid arthritis, and one each had vasculitis and scleroderma with polymyositis. There were 28 infections. One (5.3%) patient had four infections, one (5.3%) had three, six (31.6%) had two, nine (47.4%) had one, and in two (10.5%) patients the infection was not localized. Of the 19 cases, 10 (52.6%) received > 10 mg of prednisolone each day (median = 1130 mg). The remaining nine (47.4%) were on <10 mg prednisolone each day (median = 880 mg). Methylprednisolone was given to two (6.3%) patients. Bacteria accounted for most of the infections. There were two fungal infections and one patient each with tuberculosis and peritonitis. Infections occurred predominantly in the chest, urine and skin. Septicemia was diagnosed in three patients. There were two deaths, one each with SLE and rheumatoid arthritis. Conclusion: Since infections can occur at low doses of corticosteroids, we suggest that these disorders may be, per se, responsible for an increased risk of infection.

AB - Background: The widespread use of immunosuppressives in treating systemic autoimmune disorders has resulted in opportunistic infections (OIs) following such therapy. Current data regarding the possibility of infection due to these drugs or from the primary disease, per se, is conflicting. Objectives: We aimed to analyse the profile of patients requiring hospitalization for OIs among those being treated with glucocorticoids and other immunosuppressive agents as part of management of systemic autoimmune disorders and to analyse the host factors in relation to OIs. Method: In this descriptive analysis, all patients hospitalized the Postgraduate Institute of Medical Education and Research, Chandigarh, India, under medicinal units for OIs that occurred following and during treatment with corticosteroids and other immunosuppressive agents for treatment of systemic autoimmune disorders from February 2002 to January 2003, were studied. All hospitalized patients received antibiotics according to the nature of infection and sensitivity reports. All relevant clinical details were recorded in a standard pro forma. Descriptive statistics were used. The Institute Ethics Committee's permission was secured prior to study commencement. Results: Nineteen patients (16 female) were admitted because of OIs. Their mean age (± SD) was 37.32 (± 19.9) years. Ten patients had systemic lupus erythematosus (SLE), two had SLE with overlap, five had rheumatoid arthritis, and one each had vasculitis and scleroderma with polymyositis. There were 28 infections. One (5.3%) patient had four infections, one (5.3%) had three, six (31.6%) had two, nine (47.4%) had one, and in two (10.5%) patients the infection was not localized. Of the 19 cases, 10 (52.6%) received > 10 mg of prednisolone each day (median = 1130 mg). The remaining nine (47.4%) were on <10 mg prednisolone each day (median = 880 mg). Methylprednisolone was given to two (6.3%) patients. Bacteria accounted for most of the infections. There were two fungal infections and one patient each with tuberculosis and peritonitis. Infections occurred predominantly in the chest, urine and skin. Septicemia was diagnosed in three patients. There were two deaths, one each with SLE and rheumatoid arthritis. Conclusion: Since infections can occur at low doses of corticosteroids, we suggest that these disorders may be, per se, responsible for an increased risk of infection.

KW - Corticosteroids

KW - Immunosuppressives

KW - Opportunistic infections

UR - http://www.scopus.com/inward/record.url?scp=33749161896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33749161896&partnerID=8YFLogxK

U2 - 10.1111/j.1479-8077.2006.00212.x

DO - 10.1111/j.1479-8077.2006.00212.x

M3 - Article

VL - 9

SP - 269

EP - 274

JO - International Journal of Rheumatic Diseases

JF - International Journal of Rheumatic Diseases

SN - 1756-1841

IS - 3

ER -