Jesper Smit1, Mette Søgaard2, Henrik Carl Schønheyder3, Henrik Nielsen4, Trine Frøslev2, Reimar Wernich Thomsen2. 1. Department of Clinical MicrobiologyAalborg University Hospital, Aalborg, Denmark Department of Infectious DiseasesAalborg University Hospital, Aalborg, Denmark Department of Clinical EpidemiologyAarhus University Hospital, Aalborg, Denmark jesm@rn.dk. 2. Department of Clinical EpidemiologyAarhus University Hospital, Aalborg, Denmark. 3. Department of Clinical MicrobiologyAalborg University Hospital, Aalborg, Denmark Department of Clinical MedicineAalborg University, Aalborg, Denmark. 4. Department of Infectious DiseasesAalborg University Hospital, Aalborg, Denmark Department of Clinical MedicineAalborg University, Aalborg, Denmark.
Abstract
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 2638 patients with incident CA-SAB, of whom 713 (27.0%) had diabetes, and 26,379 matched population controls (2495 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)). Duration of diabetes 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 a substantially increased risk of CA-SAB, particularly in patients with diabetes of long duration, poor glycemic control, and diabetes complications.
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 2638 patients with incident CA-SAB, of whom 713 (27.0%) had diabetes, and 26,379 matched population controls (2495 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)). Duration of diabetes 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 a substantially increased risk of CA-SAB, particularly in patients with diabetes of long duration, poor glycemic control, and diabetes complications.
Authors: Taylor S Cohen; Virginia Takahashi; Jessica Bonnell; Andrey Tovchigrechko; Raghothama Chaerkady; Wen Yu; Omari Jones-Nelson; Young Lee; Rajiv Raja; Sonja Hess; C Kendall Stover; John J Worthington; Mark A Travis; Bret R Sellman Journal: J Clin Invest Date: 2019-04-15 Impact factor: 14.808
Authors: Lloyd S Miller; Vance G Fowler; Sanjay K Shukla; Warren E Rose; Richard A Proctor Journal: FEMS Microbiol Rev Date: 2020-01-01 Impact factor: 16.408