RT Journal Article SR Electronic T1 Bacteremia in systemic lupus erythematosus patients from RELESSER: risk factors, clinical and microbiological characteristics and outcomes JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.180882 DO 10.3899/jrheum.180882 A1 Iñigo Rúa-Figueroa A1 Francisco López-Longo A1 Víctor Del Campo A1 María Galindo-Izquierdo A1 Esther Uriarte A1 Julián Torre-Cisneros A1 Paloma Vela A1 Eva Tomero A1 Javier Narváez A1 Alejandro Olivé A1 Mercedes Freire A1 Eva Salgado A1 José Luis Andreu A1 Víctor Martínez-Taboada A1 Jaime Calvo-Alén A1 Blanca Hernández-Cruz A1 Enrique Raya A1 Víctor Quevedo A1 Lorena Expósito Pérez A1 Antonio Fernández-Nebro A1 Mónica Ibañez A1 Èlia Valls Pascual A1 David Rúa-Figueroa A1 Antonio Naranjo A1 José M. Pego-Reigosa YR 2019 UL http://www.jrheum.org/content/early/2019/04/09/jrheum.180882.abstract AB Objective To describe the incidence of bacteremia in a large multicentric cohort of SLE patients and their clinical characteristics and to identify risk factors. Methods All bacteremic episodes from the RELESSER registry were included. Clinical and laboratory characteristics concerning bacteremia and SLE status, as well as comorbidities at the time of infection, were retrospectively collected. A comparison with sex- and age-matched SLE controls without bacteremia was made. A logistic regression was conducted. Results A total of 114 episodes of bacteremia in 83 patients were included. The incidence rate was 2.7/ 1,000 patient-years. At the time of bacteremia, the median age was 40.5 (range: 8-90) years, and 88.6 % of patients were female; SELENA-SLEDAI: 4 (IQR:8); 41% had an SLE flare (66% severe); SLICC/ACR DI: 3 (IQR4). A comorbidity was recorded in 64% of cases. At the time of bacteremia, 88.6% received corticosteroids (68.6% >10mg/day) and 57% immunosuppressors. Gram-negative bacilli, most frequently E. coli (29.8%), caused 52.6% of the episodes. The bacteremia-related mortality was 14% and bacteremia was recurrent in 27.2% of cases. A dose-response relationship was found between corticosteroids and bacteremia risk. In the multivariate analysis, elevated creatinine [OR 1.31 (95%CI 1.01-1.70), p=0.045], diabetes [OR 6.01(2.26-15.95), p=0.000], cancer [OR 5.32 [2.23-12.70), p=0.000], immunosuppressors (OR 6.35 (3.42-11.77), p=0.000) and damage [OR 1.65(1.31-2.09), p=0.000] were associated with bacteremia. Conclusion Bacteremia occurred mostly in active SLE patients and was frequently associated with severe flares and corticosteroid use. Recurrence and mortality were high. Immunosuppressors, comorbidities and disease-related damage were associated with bacteremia.