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Statin Use and Risk of Community-Acquired Staphylococcus aureus Bacteremia: A Population-Based Case-Control Study

      Abstract

      Objective

      To ascertain whether persons treated with statins experience a decreased risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB) as compared with nonusers.

      Patients and Methods

      Using population-based medical registries, we conducted a case-control study including all adults with first-time CA-SAB and population controls matched on age, sex, and residence in Northern Denmark from January 1, 2000, through December 31, 2011. Statin users were categorized as current users (new or long-term use), former users, and nonusers. We used conditional logistic regression to compute odds ratios (ORs) for CA-SAB according to statin exposure, overall and stratified by intensity (<20, 20-39, ≥40 mg/d) and duration of use (<365, 365-1094, ≥1095 days).

      Results

      We identified 2638 patients with first-time CA-SAB and 26,379 matched population controls. Compared with nonusers, current statin users experienced markedly decreased risk of CA-SAB (adjusted OR, 0.73; 95% CI, 0.63-0.84). The adjusted OR was 0.96 (95% CI, 0.60-1.51) for new users, 0.71 (95% CI, 0.62-0.82) for long-term users, and 1.12 (95% CI, 0.94-1.32) for former users as compared with nonusers. The CA-SAB risk decreased with increasing intensity of statin use; thus, compared with nonusers, the adjusted OR was 0.84 (95% CI, 0.68-1.04) for current users with daily dosages of less than 20 mg/d, 0.71 (95% CI, 0.58-0.87) for 20 to 39 mg/d, and 0.63 (95% CI, 0.49-0.81) for 40 mg/d or more. Conversely, we observed no differences in the risk of CA-SAB with successive increases in the duration of statin use.

      Conclusion

      Statin use was associated with a decreased risk of CA-SAB, particularly in long-term users.

      Abbreviations and Acronyms:

      ATC (Anatomical Therapeutic Chemical), AUPD (Aarhus University Prescription Database), CA-SAB (community-acquired Staphylococcus aureus bacteremia), CCI (Charlson comorbidity index), DNPR (Danish National Patient Registry), OR (odds ratio), SAB (Staphylococcus aureus bacteremia)
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      Linked Article

      • Statin Use Associated With a Decreased Risk of Community-Acquired Staphylococcus aureus Bacteremia
        Mayo Clinic ProceedingsVol. 93Issue 4
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          We read with great interest the recent article by Smit et al1 on statin use associated with a decreased risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB), particularly in patients with chronic kidney disease and patients with diabetes. They explained that these results were unlikely due to direct antimicrobial effects of statins on S aureus but more likely due to the pleiotropic effects of statins reducing important isoprenoid intermediates, resulting in decreased bacterial invasion and inducing neutrophil extracellular traps.
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