Redondo-Benito A, et al. - Herein, a cohort of patients with inflammatory myopathies was analyzed to determine the prevalence, clinical characteristics and risk factors of opportunistic infection (OI) in these subjects. Also, mortality rates were compared between those with and without OIs. In this study cohort, 6.4% prevalence of OI was reported, which was higher than the rest of the inpatients of the researchers' hospital (1.7%; P < 0.01). The factors having main implications included high-dose glucocorticoids at disease onset and severe immunosuppression.

Methods

• Researchers reviewed 204 patients from their myositis cohort to identify patients who had experienced an OI during the period 1986–2014.
• A systematic record was obtained of patients’ clinical characteristics, treatments received, and outcomes.
• They analyzed disease activity at the OI diagnosis and the cumulative doses of immunosuppressive drugs, as well as the specific pathogens involved and affected organs.

Results

• Data showed that the prevalence of OI in the total cohort was 6.4%: viruses, 44.4% (varicella-zoster virus, cytomegalovirus); bacteria, 22.2% (Salmonella sp.,Mycobacterium tuberculosis, M. chelonae); fungi, 16.7% (Candida albicans,Pneumocystis jirovecii); and parasites, 16.7% (Toxoplasmosis gondii,Leishmania spp.).
• The most commonly affected organs (27.8%) included lung and skin/soft tissues.
• Overall, during the first year after the myositis diagnosis, the development of 55.6% of OIs was reported.
• In findings, OI was shown to be significantly associated with administration of high-dose glucocorticoids (P=0.0148).
• Researchers found that fever at onset of myositis (P=0.0317), biological therapy (P < 0.001) and sequential administration of 4 or more immunosuppressive agents during myositis evolution (P=0.0032) were significantly related to OI.
• In addition, they noted that all-cause mortality in the OI group was 3.69 deaths per 100 patients/year vs 3.40 in the remainder of the cohort (P=0.996).