Abstract
Introduction: Systemic autoimmune diseases are often associated with pleuropulmonary manifestations, so it is necessary to know whether underlying disease, infection or drug toxicity results in the observed changes. As confirmation of lung infection has therapeutic consequences, our aim was to determine pathogen profile of pulmonary infections in systemic autoimmune disease patients.Methods: Microbiology samples of patient with systemic autoimmune disease (N=38) referred to the Department of Pulmonology in 2012 were analyzed (age: 61,81±14,79 years; female: male= 2:1). In 42% of patients (n=16) pulmonary infection was microbiologically confirmed. Pathogen profile in rheumatoid arthritis (RA) and other connective tissue disease (CTD) subgroups were analyzed.Results: The most common bacterial infections were caused by Gram negative bacilli (Chlamydia pneumoniae (20%), Mycoplasma pneumoniae (12%), Pseudomonas aeruginosa (20%), Klebsiella pneumoniae (9%) and Stenotrophomas maltophilia (7%)). Pulmonary fungal infections (30%) were mainly caused by Candida albicans (58%) and Aspergillus species (26%). Comparing RA and CTD groups, RA patients showed lower number of yearly infection rate and lower number of concomitantly detected pathogens than CTD patients resulting in significantly shorter overall hospital stay (128 vs. 217 days).Conclusion: Pulmonary infections are common in systemic autoimmune patients, especially caused by Gram negative bacilli and fungi. Thorough microbial screening for possible pathogens is mandatory in all systemic autoimmune patients presenting with pulmonary symptoms.
- © 2014 ERS
