Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.

<h4>Introduction</h4>Statins have pleiotropic effects that could influence the prevention and outcome of some infectious diseases. There is no information about their specific effect on Staphylococcus aureus bacteremia (SAB).<h4>Methods</h4>A prospective cohort study includin...

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Autores principales:	Luis E López-Cortés, Juan Gálvez-Acebal, María D Del Toro, Carmen Velasco, Marina de Cueto, Francisco J Caballero, Miguel A Muniain, Alvaro Pascual, Jesús Rodríguez-Baño
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dd7490914827423f89f4639150b78b19
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spelling	oai:doaj.org-article:dd7490914827423f89f4639150b78b192021-11-18T08:40:40ZEffect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.1932-620310.1371/journal.pone.0082958https://doaj.org/article/dd7490914827423f89f4639150b78b192013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24376617/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>Statins have pleiotropic effects that could influence the prevention and outcome of some infectious diseases. There is no information about their specific effect on Staphylococcus aureus bacteremia (SAB).<h4>Methods</h4>A prospective cohort study including all SAB diagnosed in patients aged ≥18 years admitted to a 950-bed tertiary hospital from March 2008 to January 2011 was performed. The main outcome variable was 14-day mortality, and the secondary outcome variables were 30-day mortality, persistent bacteremia (PB) and presence of severe sepsis or septic shock at diagnosis of SAB. The effect of statin therapy at the onset of SAB was studied by multivariate logistic regression and Cox regression analysis, including a propensity score for statin therapy.<h4>Results</h4>We included 160 episodes. Thirty-three patients (21.3%) were receiving statins at the onset of SAB. 14-day mortality was 21.3%. After adjustment for age, Charlson index, Pitt score, adequate management, and high risk source, statin therapy had a protective effect on 14-day mortality (adjusted OR = 0.08; 95% CI: 0.01-0.66; p = 0.02), and PB (OR = 0.89; 95% CI: 0.27-1.00; p = 0.05) although the effect was not significant on 30-day mortality (OR = 0.35; 95% CI: 0.10-1.23; p = 0.10) or presentation with severe sepsis or septic shock (adjusted OR = 0.89; CI 95%: 0.27-2.94; p = 0.8). An effect on 30-day mortality could neither be demonstrated on Cox analysis (adjusted HR = 0.5; 95% CI: 0.19-1.29; p = 0.15).<h4>Conclusions</h4>Statin treatment in patients with SAB was associated with lower early mortality and PB. Randomized studies are necessary to identify the role of statins in the treatment of patients with SAB.Luis E López-CortésJuan Gálvez-AcebalMaría D Del ToroCarmen VelascoMarina de CuetoFrancisco J CaballeroMiguel A MuniainAlvaro PascualJesús Rodríguez-BañoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 12, p e82958 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luis E López-Cortés Juan Gálvez-Acebal María D Del Toro Carmen Velasco Marina de Cueto Francisco J Caballero Miguel A Muniain Alvaro Pascual Jesús Rodríguez-Baño Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.
description	<h4>Introduction</h4>Statins have pleiotropic effects that could influence the prevention and outcome of some infectious diseases. There is no information about their specific effect on Staphylococcus aureus bacteremia (SAB).<h4>Methods</h4>A prospective cohort study including all SAB diagnosed in patients aged ≥18 years admitted to a 950-bed tertiary hospital from March 2008 to January 2011 was performed. The main outcome variable was 14-day mortality, and the secondary outcome variables were 30-day mortality, persistent bacteremia (PB) and presence of severe sepsis or septic shock at diagnosis of SAB. The effect of statin therapy at the onset of SAB was studied by multivariate logistic regression and Cox regression analysis, including a propensity score for statin therapy.<h4>Results</h4>We included 160 episodes. Thirty-three patients (21.3%) were receiving statins at the onset of SAB. 14-day mortality was 21.3%. After adjustment for age, Charlson index, Pitt score, adequate management, and high risk source, statin therapy had a protective effect on 14-day mortality (adjusted OR = 0.08; 95% CI: 0.01-0.66; p = 0.02), and PB (OR = 0.89; 95% CI: 0.27-1.00; p = 0.05) although the effect was not significant on 30-day mortality (OR = 0.35; 95% CI: 0.10-1.23; p = 0.10) or presentation with severe sepsis or septic shock (adjusted OR = 0.89; CI 95%: 0.27-2.94; p = 0.8). An effect on 30-day mortality could neither be demonstrated on Cox analysis (adjusted HR = 0.5; 95% CI: 0.19-1.29; p = 0.15).<h4>Conclusions</h4>Statin treatment in patients with SAB was associated with lower early mortality and PB. Randomized studies are necessary to identify the role of statins in the treatment of patients with SAB.
format	article
author	Luis E López-Cortés Juan Gálvez-Acebal María D Del Toro Carmen Velasco Marina de Cueto Francisco J Caballero Miguel A Muniain Alvaro Pascual Jesús Rodríguez-Baño
author_facet	Luis E López-Cortés Juan Gálvez-Acebal María D Del Toro Carmen Velasco Marina de Cueto Francisco J Caballero Miguel A Muniain Alvaro Pascual Jesús Rodríguez-Baño
author_sort	Luis E López-Cortés
title	Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.
title_short	Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.
title_full	Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.
title_fullStr	Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.
title_full_unstemmed	Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.
title_sort	effect of statin therapy in the outcome of bloodstream infections due to staphylococcus aureus: a prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/dd7490914827423f89f4639150b78b19
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Effect of statin therapy in the outcome of bloodstream infections due to Staphylococcus aureus: a prospective cohort study.

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