Research Article

Infections Caused by Extended-Spectrum β-Lactamase Producing Escherichia Coli in Systemic Lupus Erythematosus Patients: Prevalence, Risk Factors, and Predictive Model

Table 3

(a) Demographics and clinical characteristics of SLE patients infected by E. coli

Characteristics ESBL (+)ESBL (-)P value
(n, % / mean±SD)n=212n=172

Age,yrs49.5±8.247.9±9.80.098
Female gender206 (97.2)163 (94.8)0.227
ICU stay during hospitalization35 (16.5)11 (6.4)0.002
Long of hospital stay, days11.3±4.210.5±5.60.111
Hospitalization ≥ 48 hours in preceding 90 days40 (18.9)33 (19.2)0.937
Enterobacteriaceae colonization or infection in preceding year37 (17.5)6 (3.5)<0.001
Mechanical ventilation ≥ 48 hours19 (8.9)6 (3.5)0.031
Deep vein catheter ≥ 48 hours29 (13.7)18 (10.5)0.339
Urethral catheter≥ 48 hours27 (12.7)8 (4.7)0.006
Residence of nursing home33 (15.7)11 (6.4)0.005
Nosocomial acquired infection41 (19.3)18 (10.5)0.026
Mortality27 (12.7)9 (5.2)0.012

ESBL, Extended-Spectrum -Lactamase; ICU, intensive care unit.
(b) SLE status of the patients infected by E. coli

Characteristic (n)ESBL (+)ESBL (-)P value
(n, % / mean±SD)n=212n=172

SLE activity at the time of infection
 Lupus nephritis42 (19.8)32 (18.6)0.766
 Hematological activity24 (11.3)9 (5.2)0.034
 Central nervous system activity7 (3.3)3 (1.7)0.341
Course of SLE, month42.5±11.340.2±14.70.084
Immunosuppressive treatment45 (21.2)25 (14.5)0.058
Daily prednisone dose at the time of infection, mg28.4±7.310.6±3.2<0.001
Positive anti-dsDNA146 (68.9)112 (65.1)0.436
Low C3 levels163 (76.9)91 (52.9)<0.001
Lymphopenia,<1000/ml74 (34.9)49 (28.5)0.181
SLEDAI score11.4±5.35.2±2.1<0.001

ESBL, Extended-Spectrum -Lactamase; C3, Complement 3; SLE, systemic lupus erythematosus; SLEDAI, systemic lupus erythematosus disease activity index.
(c) Antibiotics prescription within 30 days before the patients infected by E. coli

Prior Antibiotics (n, %)ESBL (+)ESBL (-)P value
n=212n=172

Aminoglycosides81 (38.2)27 (15.7)<0.001
Carbapenem60 (28.3)38 (22.1)0.165
Co-trimoxazole16 (7.5)21 (12.2)0.124
Penicillin group28 (13.2)19 (11.0)0.521
Quinolones67 (31.6)38 (22.1)0.038
First-generation cephalosporins7 (3.3)4 (2.3)0.568
Second-generation cephalosporins11 (5.2)7 (4.1)0.606
Third-generation cephalosporins55 (25.9)18 (10.5)<0.001
Forth-generation cephalosporins26 (12.3)17 (9.9)0.462
-Lactam/-lactamase inhibitors37 (17.5)39 (22.6)0.202

ESBL, Extended-Spectrum -Lactamase.