title: Urinary tract infections and lupus erythematosus.
abstract: BACKGROUND
  Infections are one of the main causes of morbidity and mortality in patients with systemic lupus erythematosus.
  
  
  OBJECTIVE
  To analyse urinary tract infection (UTI) risk factors in lupus patients; the influence of these factors on disease activity, organ damage, and disease development; the type and prevalence of UTI; and the micro-organisms involved.
  
  
  METHODS
  86 control subjects and 81 lupus patients were studied prospectively over a 12 month period and examined on five occasions. Epidemiological data and information on urinary symptoms, disease activity (SLEDAI), and organ damage (SLICC/ACR) data were collected. Autoantibodies, complement levels, urine culture, and antibiogram were determined; urological studies were also carried out. SPPS 10.0 and STATA 6.0. were used for statistical analysis.
  
  
  RESULTS
  The prevalence of UTI in lupus patients was 36%. Lupus influences the onset of UTI (p = 0.001), regardless of other variables. UTI risk factors in lupus patients were age (p = 0.002), previous cases of UTI (p = 0.0001), antinuclear antibodies (ANA) >1/80 IU/ml (p = 0.022), thrombocytopenia (p = 0.02), and admission to hospital due to UTI (p = 0.002). Leucopenia (p = 0.09) and the weekly administration of methotrexate (p = 0.06) had a bearing on the onset of UTI; disease development (p = 0.99), lupus activity (p = 0.32), and organ damage (p = 0.36) do not. The uropathogen most frequently isolated was E coli (60%).
  
  
  CONCLUSIONS
  Lupus patients are likely to have UTI, usually manifesting in the lower tract. They are community acquired, basically caused by E coli, and favoured by age, previous UTI, admissions to hospital due to UTI, thrombopenia, ANA, leucopenia, and methotrexate treatments.
authors.affiliation: Systemic Autoimmune Diseases Unit, Service of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain. chidalgo72@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Hidalgo-Tenorio
authors.forename: J
authors.initials: J
authors.lastname: Jiménez-Alonso
authors.forename: J
authors.initials: J
authors.lastname: de Dios Luna
authors.forename: M
authors.initials: M
authors.lastname: Tallada
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Brocal
authors.forename: J Mario
authors.initials: JM
authors.lastname: Sabio
mesh_terms: D000328:Adult; D000367:Age Factors; D000974:Antibodies, Antinuclear / Q000032:analysis; D018501:Antirheumatic Agents / Q000009:adverse effects; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006760:Hospitalization; D006801:Humans; D007970:Leukopenia / Q000150:complications; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013921:Thrombocytopenia / Q000150:complications; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology
chemical_list: D000974:Antibodies, Antinuclear; D018501:Antirheumatic Agents; D008727:Methotrexate