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)To read this article in full you will need to make a payment
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Article Info
Footnotes
For editorial comment, see page 1463
Grant Support: The work was supported by research grants from the Heinrich Kopp, Hertha Christensen, and North Denmark Health Sciences Research foundations. Dr López-Cortés and Dr Rodríguez-Bãno received research funding from the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III, co-financed by the European Development Regional Fund “A way to achieve Europe” (ERDF), Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015).
Potential Competing Interests: Dr López-Cortés has received payments from Merck Sharp & Dohme and Angelini. Dr Nielsen serves on the advisory board of Gilead. Dr Rodríguez-Bãno has received honoraria from AstraZeneca and Merck.
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- Statin Use Associated With a Decreased Risk of Community-Acquired Staphylococcus aureus BacteremiaMayo Clinic ProceedingsVol. 93Issue 4
- PreviewWe 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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