AUTHOR=Chu Kuo-An , Ou Ting-Yun , Hung Wei-Hsin , Sung Jie , Chen Weishan , Lin Cheng-Li , Hung Yao-Min , Wei James Cheng-Chung 

TITLE=Mycoplasma pneumonia Infection Is Associated With an Increased Risk of Systemic Lupus Erythematosus: A Nationwide, Retrospective Cohort Study

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.815136

DOI=10.3389/fmicb.2022.815136

ISSN=1664-302X

ABSTRACT=<sec><title>Background</title><p>Infections may play a role in the development of systemic lupus erythematosus (SLE).</p></sec><sec><title>Objective</title><p>To assess the link between <italic>Mycoplasma pneumonia</italic> (<italic>M. pneumonia</italic>) infection and the incidence of SLE.</p></sec><sec><title>Method</title><p>We conducted a retrospective cohort study, which identified 116,043 hospitalized patients with <italic>M. pneumoniae</italic> between 2000 and 2012 from the Taiwan National Health Insurance Research Database and compared them with 447,839 matched inpatients who had never been diagnosed with <italic>M. pneumonia</italic> infection (at a 1:4 ratio, matched by age, gender, and index year). Their comparative risk of developing SLE was evaluated. The follow-up period was defined as the time from the initial diagnosis of <italic>M. pneumonia</italic> infection to the date of SLE diagnosis, or December 31, 2013. The incidence rates of SLE were assessed in people with and without <italic>M. pneumoniae</italic> infection. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), with the uninfected group used as the reference.</p></sec><sec><title>Results</title><p>The adjusted HR of SLE for the <italic>M. pneumoniae</italic> group was 2.97 with 95% CI = 2.18–4.05 compared with the uninfected group. The risk was most significantly higher within 0.5 years after the <italic>M. pneumoniae</italic> infection with an adjusted HR of 6.18 (95% CI = 3.82–9.97, <italic>p</italic> &lt; 0.01). The adjusted HR for SLE from 0.5 to 2 years and from 2 to 5 years after <italic>M. pneumoniae</italic> infection was 1.59 (95% CI = 0.70–3.59, <italic>p</italic> = 0.27) and 2.42 (95% CI = 1.22–4.81, <italic>p</italic> = 0.01), respectively.</p></sec><sec><title>Conclusion</title><p>The incidence of SLE was significantly higher in subjects infected with <italic>M. pneumoniae</italic>.</p></sec>