Risk of Infections in Bronchiectasis During Disease-Modifying Treatment and Biologics for Rheumatic Diseases

BMC Infect Dis. 2011 Nov 2;11:304. doi: 10.1186/1471-2334-11-304.

Abstract

Background: Bronchiectasis is frequently associated (up to 30%) with chronic inflammatory rheumatic diseases and leads to lower respiratory tract infections. Data are lacking on the risk of lower respiratory tract infections in patients treated with biologic agents.

Methods: Monocenter, retrospective systematic study of all patients with a chronic inflammatory rheumatic disease and concomitant bronchiectasis, seen between 2000 and 2009. Univariate and multivariate analyses were performed to evidence predictive factors of the number of infectious respiratory events.

Results: 47 patients were included (mean age 64.1±9.1 years, 33 (70.2%) women), with a mean follow-up per patient of 4.3±3.1 years. Rheumatoid arthritis was the main rheumatic disease (90.1%). The mean number of infectious events was 0.8±1.0 event per patient-year. The factors predicting infections were the type of treatment (biologic vs. non biologic disease-modifying treatments), with an odds ratio of 8.7 (95% confidence interval: 1.7-43.4) and sputum colonization by any bacteria (odds ratio 7.4, 2.0-26.8). In multivariate analysis, both factors were independently predictive of infections.

Conclusion: Lower respiratory tract infectious events are frequent among patients receiving biologics for chronic inflammatory rheumatic disease associated with bronchiectasis. Biologic treatment and pre-existing sputum colonization are independent risk factors of infection occurrence.

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / adverse effects
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology
  • Biological Products / administration & dosage*
  • Biological Products / adverse effects
  • Bronchiectasis / complications*
  • Bronchitis / epidemiology*
  • Bronchitis / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / drug therapy*
  • Risk Assessment

Substances

  • Antirheumatic Agents
  • Biological Products