PMID- 36270741
OWN - NLM
STAT- MEDLINE
DCOM- 20221025
LR  - 20221114
IS  - 2056-5933 (Electronic)
IS  - 2056-5933 (Linking)
VI  - 8
IP  - 2
DP  - 2022 Oct
TI  - Association between different infection profiles and one-year outcomes in 
      ANCA-associated vasculitis: a retrospective study with monthly infection 
      screening.
LID - 10.1136/rmdopen-2022-002424 [doi]
LID - e002424
AB  - OBJECTIVES: This study aimed to explore clinical features of early infection in 
      patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and 
      to identify the association between the infection profile of patients with AAV 
      during the first 3 months and 1-year survival. METHODS: A total of 415 newly 
      diagnosed patients with AAV in the Department of Nephrology at Shanghai Ruijin 
      Hospital from 2000 to 2018 were included. Four Cox regression models were used to 
      analyse the association based on demographics, comorbidities, laboratory baseline 
      index and therapy parameter. Infection screening was carried out monthly during 
      the first 3 months after diagnosis. RESULTS: In all, 377 episodes of infection 
      were identified among 220 patients during the first 3 months. The overall 
      survival after 1 year was 73.0%. Respiratory infection (210 episodes/164 persons) 
      accounted for more than half of infections. Infection was independently 
      associated with 1-year mortality (adjusted HR 2.32, 95% CI 1.27 to 4.23, p=0.006) 
      after adjustment. Respiratory infection (adjusted HR 4.36, 95% CI 2.86 to 8.06, 
      p<0.001), Gram-negative bacterial infection (adjusted HR 1.71, 95% CI 1.01 to 
      2.91, p=0.047) and fungal infection (adjusted HR 1.77, 95% CI 1.07 to 2.94, 
      p=0.026) was identified as a risk factor for 1-year mortality. 
      Trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis (adjusted HR 0.55, 95% CI 
      0.31 to 0.97, p=0.040) was protective for 1-year mortality. CONCLUSIONS: 
      Infections, particularly respiratory infections, are a common and important class 
      of complication in patients with AAV and are associated with early mortality. 
      TMP-SMX prophylaxis might be necessary to improve short-term outcome. More 
      consideration of infectious risk and regular infection screening should be given.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Xu, Tingting
AU  - Xu T
AUID- ORCID: 0000-0002-0747-604X
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Chen, Zijin
AU  - Chen Z
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Jiang, Mengdi
AU  - Jiang M
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Ma, Hunkun
AU  - Ma H
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Jin, Kexin
AU  - Jin K
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Wang, Zhiyu
AU  - Wang Z
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Wang, Chongjian
AU  - Wang C
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Xu, Jing
AU  - Xu J
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China.
FAU - Zhang, Wen
AU  - Zhang W
AD  - Nephrology, Shanghai Jiao Tong University Medical School Affiliated Ruijin 
      Hospital, Shanghai, China zhangwen255@163.com.
LA  - eng
PT  - Journal Article
PL  - England
TA  - RMD Open
JT  - RMD open
JID - 101662038
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Humans
MH  - *Antibodies, Antineutrophil Cytoplasmic/therapeutic use
MH  - Retrospective Studies
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
MH  - China
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/complications/diagnosis/drug therapy
PMC - PMC9594583
OTO - NOTNLM
OT  - autoimmune diseases
OT  - granulomatosis with polyangiitis
OT  - systemic vasculitis
COIS- Competing interests: None declared.
EDAT- 2022/10/22 06:00
MHDA- 2022/10/26 06:00
PMCR- 2022/10/21
CRDT- 2022/10/21 21:08
PHST- 2022/05/05 00:00 [received]
PHST- 2022/09/25 00:00 [accepted]
PHST- 2022/10/21 21:08 [entrez]
PHST- 2022/10/22 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/10/21 00:00 [pmc-release]
AID - rmdopen-2022-002424 [pii]
AID - 10.1136/rmdopen-2022-002424 [doi]
PST - ppublish
SO  - RMD Open. 2022 Oct;8(2):e002424. doi: 10.1136/rmdopen-2022-002424.