Diabetes and risk of community-acquired Staphylococcus aureus bacteremia: A population-based case-control study

March 22, 2016 at 10:40 pm

Eur J Endocrinol March 10, 2016

Jesper Smith, Mette Søgaard, Henrik Carl Schønheyder, Henrik Nielsen, Trine Frøslev and Reimar Wernich Thomsen

J Smit, Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark

M Søgaard, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

H Schønheyder, Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark

H Nielsen, Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark

T Frøslev, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

R Thomsen, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

Correspondence: Jesper Smit, Email: jesm@rn.dk

Objective

Patients with diabetes may experience higher risk of Staphylococcus aureus bacteremia (SAB) than patients without diabetes due to decreased immunity or coexisting morbidities. We investigated the risk of community-acquired (CA) SAB in persons with and without diabetes.

Design

Using population-based medical databases, we conducted a case-control study of all adults with first-time CA-SAB and matched population controls in Northern Denmark, 2000-2011.

Methods

Based on conditional logistic regression, we computed odds ratios (ORs) of CA-SAB according to diabetes. We further assessed whether the risk of CA-SAB differed according to various diabetes-related characteristics (e.g. duration of diabetes, glycemic control, and presence of diabetes complications).

Results

We identified 2,638 patients with incident CA-SAB of which 713 (27.0%) had diabetes, and 26,379 matched population controls (2,495 or 9.5% with diabetes). Individuals with diabetes had a substantially increased risk of CA-SAB compared with population controls (adjusted OR=2.8 (95% confidence interval (CI), 2.5-3.1)). Diabetes duration of ≥10 years and poor glycemic control conferred higher risk estimates, with an adjusted OR=2.3 (95% CI, 1.9-2.7) for diabetes with Hba1c <7% (<53 mmol/mol) and an adjusted OR=5.7 (95% CI, 4.2-7.7) for diabetes with Hba1c ≥9% (≥75 mmol/mol). The risk of CA-SAB was particularly high in patient with diabetes complications: adjusted OR=5.5 (95% CI, 4.2-7.2) with presence of microvascular complications and OR=7.0 (95% CI, 5.4-9.0) with combined macro- and microvascular complications.

Conclusions

Diabetes is associated with substantially increased risk of CA-SAB, particularly among patients with diabetes of long duration, poor glycemic control, and diabetes complications.

abstract

http://www.eje-online.org/content/early/2016/03/10/EJE-16-0023

PDF

http://www.eje-online.org/content/early/2016/03/10/EJE-16-0023.full.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Infecciones en diabeticos, Metodos diagnosticos, Sepsis, Update. Tags: .

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