bacterial infection in the limbs of patients with rheumatoid arthritis during biological agent therapy细菌感染患者的四肢在生物制剂治疗类风湿性关节炎.pdfVIP

Open Journal of Rheumatology and Autoimmune Diseases, 2012, 2, 47-52 47 /10.4236/ojra.2012.23010 Published Online August 2012 (http://www.SciRP.org/journal/ojra) Bacterial Infection in the Limbs of Patients with * Rheumatoid Arthritis during Biological Agent Therapy # † † Hajime Yamanaka , Kenichiro Goto , Munetaka Suzuki Department of Orthopaedic Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Japan. Email: #ici05323@m7.gyao.ne.jp, g10k25@yahoo.co.jp, rcjqq173@ybb.ne.jp Received March 2nd, 2012; revised April 12th, 2012; accepted April 25th, 2012 ABSTRACT Biological therapies in rheumatoid arthritis (RA) are known to increase the risk of serious infections. The present study was performed to evaluate the clinical features of bacterial infections occurring in the limbs during biological therapies in patients with RA. By March 2011, 11 RA patients (14 limbs) treated with biological agents at our institution required hospitalization due to bacterial infections occurring in the limbs. These patients had an average age of 53.7 years old. Infections occurred an average of 19 months after biological treatment. Two limbs in one patient were treated with in- fliximab, eight limbs in six patients were treated with etanercept, one limb in one patient was treated with adalimumab, and three limbs in three patients were treated with tocilizumab. Cellulitis occurred in 7 limbs, late infections after total knee arthroplasty occurred in two limbs, early infections after orthopedic surgery occurred in three limbs, and septic arthritis occurred in two limbs. Four cases had comorbidities—liver cirrhosis and diabetes mellitus in