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In Reply—Statin Use Associated With a Decreased Risk of Community-Acquired Staphylococcus aureus Bacteremia

      We appreciate Dr Ko and colleagues’ interesting reflections on our findings concerning the influence of statin use on the risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB). Because the aim of our study was to provide epidemiological in vivo data on this association, Ko and colleagues’ review of the literature and considerations on the potential underlying pathophysiologic mechanisms constitute a very valuable supplement to our paper. We agree that the risk of CA-SAB appeared to differ slightly across the different types of statins (simvastatin, atorvastatin, and others). However, because only 9% of current statin users were treated with other statins and because the confidence intervals for the estimates overlapped, these results should be interpreted with caution.
      As suggested in the letter by Ko et al, we believe that future well-conducted basic and clinical research represents the only way to disentangle the biological mechanisms by which statin treatment may protect against CA-SAB.

      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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