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Incidence of bloodstream infections three times higher in patients with JIA
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Incidence of bloodstream infections in patients with juvenile idiopathic arthritis were rare, but occurred three times more often than in the general population, according to study findings.
Researchers identified 1,604 patients with juvenile idiopathic arthritis (JIA) and their medications from the Social Insurance Institution’s (SIIs) national register between 2004 and 2011. They then combined the National Infectious Disease Register (NIDR) — which collects data from blood culture positive samples from all Finish microbiology laboratories — and the SII register to identify all patients with JIA and bloodstream infections (BSIs). Mean patient age was 8.2 years; 992 patients were girls and 612 were boys.
Methotrexate was the most commonly prescribed disease-modifying anti-rheumatic drug (DMARD, 60%) followed by hydroxychloroquine (30%) and sulfasalazine (7%).
BSIs, including Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli and Fusobacterium necrophorum infections, were identified using the NIDR.
Five patients with JIA who acquired BSIs were identified during the study period. The incidence of BSIs were 7.5 per 10,000 compared with 2.8 per 10,000 in the general population, according to the researchers. Three of the infected patients were prescribed DMARDs, including two who were taking tumor necrosis factor inhibitors.
“Although low, the incidence of BSI in this population was no less than three-fold higher than among the general population,” the researchers wrote. “The increased risk for BSI was not apparently associated with the use of immunosuppressive therapy, suggesting that the current guidelines for early active therapy of JIA are reasonably safe in terms of infectious adverse events.”
Disclosure: The authors reported no financial disclosures.
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