Features and associated factors of bacterial skin infections in hospitalized patients with pemphigus: a single-center re
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Annals of Clinical Microbiology and Antimicrobials Open Access
RESEARCH
Features and associated factors of bacterial skin infections in hospitalized patients with pemphigus: a single‑center retrospective study Furong Li1,2,3†, Yejun Wu4†, Wenjie Bian4, Lei Huang5, Xuejun Zhu1,2,3, Xixue Chen1,2,3 and Mingyue Wang1,2,3*
Abstract Background: Infections were the primary cause of death (34.3–55.5%) in patients with pemphigus. Skin was usually the origin of infections. The study aimed to explore features and associated factors of bacterial skin infections (BSIs) in inpatients with pemphigus. Methods: One hundred and seventy-seven inpatients with pemphigus hospitalizing from November 2014 to April 2019 were continuouslyrecruited through Peking University First Hospital’s inpatient records inpatients with pemphigus hospitalizing from November 2014 to April 2019 were continuously recruited through Peking University First Hospital’s inpatient records. Then, we retrieved the clinical and laboratory data to explore the characteristics and associated factors of BSIs. Results: Of patients enrolled, pemphigus vulgaris (PV, n = 142) and pemphigus foliaceus (PF, n = 9) were most common, followed by pemphigus erythematosus (PE, n = 25) and pemphigus vegetans (Pveg, n = 1). Eighty-seven of 177 (49.2%) inpatients developed BSIs, and they had a longer length of stay compared with inpatients without BSIs (median: 18.9 vs. 14.1 days, p = 0.008). Staphylococcus aureus was the most common bacteria (71.3%, 62/87) and highly resistant to penicillin (91.9%, 57/62). Higher levels of anti-Dsg1 autoantibodies (> 124.2 U/mL) (p 169.5 U/mL) (p = 0.03, OR = 2.074, 95% CI: 1.084–3.969) were underlying risk factors of BSIs when analyzed by binary regression analysis. As for Gram’s stain of bacteria, females had a lower rate of Gram-positive infections (p = 0.03). Patients using oral antibiotics (p = 0.05) had a higher rate of Gram-negative infections. Inpatients who were hospitalized in other hospitals within 2 weeks before the current admission had a higher rate of Gram-negative and co-infections (p = 0.03). Conclusions: Inpatients with pemphigus had a high incidence of BSIs. Some factors were associated with the susceptibility of BSIs and bacterial species. Keywords: Bacterial skin infections, Pemphigus, Antibiotics, Gram’s stain, Staphylococcus aureus
*Correspondence: [email protected] † Furong Li and Yejun Wu contributed equally 1 Department of Dermatology, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing 100034, China Full list of author information is available at the end of the article
Introduction Pemphigus is an autoimmune bullous disease characterized by flaccid blisters and erosions of skin/ mucous membranes [1]. Annual incidence varies from 0.76 to 16.1 cases per million [2, 3]. Subtypes of pemphigus were differentiated by clinical features,
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