Abstract：
Infections in patients with systemic vasculitis represent one of the main causes of mortality. Corticosteroid use, immunosuppressive therapy, age, associated organic involvement and dialysis dependence are risk factors of infection.
OBJECTIVE: To determine the prevalence of severe infection and associated factors in patients diagnosed with ANCA-associated vasculitis (AAV) and Polyarteritis Nodosa (PAN).
METHODS: retrospective study was conduced in a single rheumatology center (2000-2018). We included patients diagnosed with AAV (Granulomatosis with Polyangiitis (GPA), Eosinophilic Granulomatosis with Polyangiitis (EGPA) and Microscopic Polyangiitis (PAM) and Polyarteritis nodosa (PAN). Serious infectious events requiring hospitalisation or prolonged antibiotic/antiviral treatment, recurrent infection of Herpes Zoster Virus or opportunistic infections were evaluated. Sites of infection, isolated microorganisms and mortality related were analyzed.
RESULTS: 105 patients were analyzed, follow-up time median 18 m, 58.7% were women and median age was 52 years. Types of vasculitis: 41.9% PAM, 16.2% EPGA, 40% GPA, 1.9% PAN. Constitutional, pulmonary, renal and otorhinolaryngology manifestations were the most frequent.
UNASSIGNED: 34.2%, with a median of 3 months from diagnosis of vasculitis to the infectious event. Low respiratory tract (42.8%), sepsis (31.4%), and urinary tract (14.3%) were the most common sites of infections. Bacterial aetiology was the most prevalent (67.7%). Mortality at the first event was 14.3% and a 72.2% of patients were in the induction phase of treatment. Infectious events were significantly associated with age > 65 years (p = 0.030), presence of lung (p = 0.016) and renal involvement (p = 0.001), BVASv3 > 15, mortality (p = 0.0002).
CONCLUSIONS: The prevalence of infection was 34.2%. Lower airway infections, septicemia and urinary tract infections were the most prevalent. Infections were associated with renal and pulmonary involvement, age older than 65 years and score BVAS > 15. Severe infections were associated with mortality, especially in elderly patients.
OBJECTIVE: To determine the prevalence of severe infection and associated factors in patients diagnosed with ANCA-associated vasculitis (AAV) and Polyarteritis Nodosa (PAN).
METHODS: retrospective study was conduced in a single rheumatology center (2000-2018). We included patients diagnosed with AAV (Granulomatosis with Polyangiitis (GPA), Eosinophilic Granulomatosis with Polyangiitis (EGPA) and Microscopic Polyangiitis (PAM) and Polyarteritis nodosa (PAN). Serious infectious events requiring hospitalisation or prolonged antibiotic/antiviral treatment, recurrent infection of Herpes Zoster Virus or opportunistic infections were evaluated. Sites of infection, isolated microorganisms and mortality related were analyzed.
RESULTS: 105 patients were analyzed, follow-up time median 18 m, 58.7% were women and median age was 52 years. Types of vasculitis: 41.9% PAM, 16.2% EPGA, 40% GPA, 1.9% PAN. Constitutional, pulmonary, renal and otorhinolaryngology manifestations were the most frequent.
UNASSIGNED: 34.2%, with a median of 3 months from diagnosis of vasculitis to the infectious event. Low respiratory tract (42.8%), sepsis (31.4%), and urinary tract (14.3%) were the most common sites of infections. Bacterial aetiology was the most prevalent (67.7%). Mortality at the first event was 14.3% and a 72.2% of patients were in the induction phase of treatment. Infectious events were significantly associated with age > 65 years (p = 0.030), presence of lung (p = 0.016) and renal involvement (p = 0.001), BVASv3 > 15, mortality (p = 0.0002).
CONCLUSIONS: The prevalence of infection was 34.2%. Lower airway infections, septicemia and urinary tract infections were the most prevalent. Infections were associated with renal and pulmonary involvement, age older than 65 years and score BVAS > 15. Severe infections were associated with mortality, especially in elderly patients.
摘要：
全身性血管炎患者的感染是死亡的主要原因之一。使用皮质类固醇,免疫抑制治疗,年龄,相关的器质性受累和透析依赖是感染的危险因素。
目的：确定诊断为ANCA相关性血管炎（AAV）和结节性多动脉炎（PAN）的患者中严重感染的患病率及相关因素。
方法：回顾性研究在一家风湿病中心（2000-2018年）进行。我们纳入了诊断为AAV（肉芽肿性多血管炎（GPA），嗜酸性肉芽肿性多血管炎（EGPA）和显微镜多血管炎（PAM）和结节性多动脉炎（PAN）。需要住院治疗或延长抗生素/抗病毒治疗的严重感染事件，对带状疱疹病毒反复感染或机会性感染进行了评估.感染部位,分离的微生物和死亡率进行了分析。
结果：分析了105例患者，随访时间中位数18米，58.7%为女性，中位年龄为52岁。血管炎的类型：41.9%PAM，16.2%EPGA,40%GPA,1.9%PAN。宪法,肺,肾脏和耳鼻咽喉科表现最常见。
■34.2%，从血管炎诊断到感染事件的中位数为3个月。低呼吸道(42.8%),脓毒症（31.4%），尿路（14.3％）是最常见的感染部位。细菌病因最普遍(67.7%)。第一个事件的死亡率为14.3％，72.2％的患者处于治疗的诱导期。感染事件与年龄>65岁显著相关(p=0.030),存在肺（p=0.016）和肾脏受累（p=0.001），BVASv3>15,死亡率(p=0.0002)。
结论：感染患病率为34.2％。下气道感染,败血症和尿路感染最普遍。感染与肾脏和肺部受累有关，年龄大于65岁，BVAS评分>15。严重感染与死亡率相关，尤其是老年患者。
目的：确定诊断为ANCA相关性血管炎（AAV）和结节性多动脉炎（PAN）的患者中严重感染的患病率及相关因素。
方法：回顾性研究在一家风湿病中心（2000-2018年）进行。我们纳入了诊断为AAV（肉芽肿性多血管炎（GPA），嗜酸性肉芽肿性多血管炎（EGPA）和显微镜多血管炎（PAM）和结节性多动脉炎（PAN）。需要住院治疗或延长抗生素/抗病毒治疗的严重感染事件，对带状疱疹病毒反复感染或机会性感染进行了评估.感染部位,分离的微生物和死亡率进行了分析。
结果：分析了105例患者，随访时间中位数18米，58.7%为女性，中位年龄为52岁。血管炎的类型：41.9%PAM，16.2%EPGA,40%GPA,1.9%PAN。宪法,肺,肾脏和耳鼻咽喉科表现最常见。
■34.2%，从血管炎诊断到感染事件的中位数为3个月。低呼吸道(42.8%),脓毒症（31.4%），尿路（14.3％）是最常见的感染部位。细菌病因最普遍(67.7%)。第一个事件的死亡率为14.3％，72.2％的患者处于治疗的诱导期。感染事件与年龄>65岁显著相关(p=0.030),存在肺（p=0.016）和肾脏受累（p=0.001），BVASv3>15,死亡率(p=0.0002)。
结论：感染患病率为34.2％。下气道感染,败血症和尿路感染最普遍。感染与肾脏和肺部受累有关，年龄大于65岁，BVAS评分>15。严重感染与死亡率相关，尤其是老年患者。
