Statin use potentially reduces risk of bacterial bloodstream infection

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A group of researchers have recently published a study in Mayo Clinic Proceedings, which reveals that statin users have a 27% lower risk of contracting Staphylococcus aureus bloodstream infections outside of hospitals. In particular, elderly patients with pre-existing chronic conditions (e.g., diabetes) taking statins may be more protected against infection.

By using population-based medical registries, the researchers conducted a case-control study of all adults with first-time community-acquired S. aureus bacteremia (CA-SAB) and population controls. The team analyzed records of around 30,000 people using Danish medical registries over a 12-year period from 1 January 2000 to 31 December 2011.

During their investigation, they were able to identify 2,638 cases of CA-SAB. In addition to this, 26,379 individuals were matched by age, sex and residence against the cases as controls. The CA-SAB cases revealed that 368 (14.0%) were current users of statin medications, whereas the control cases displayed 3,221 (12.2%) users, respectively.

In addition to this, researchers also investigated the susceptibility of infection by taking the following parameters into account: duration of current or former statin use, 90-day cumulative dose, and specific subgroups of patients who were prescribed statins for different chronic conditions (e.g., previous myocardial infarction, peripheral arterial disease, chronic heart failure, chronic kidney disease, and diabetes).

The results of their investigation revealed that the risk for CA-SAB gradually decreased with increasing statin dosage. This trend was most evident in patients with chronic kidney disease and diabetes. Individuals who were current users of statin displayed a 27% decrease in CA-SAB risk and long-term users had a 30% decrease, with new users showing a 4% decrease.

Jesper Smit (Aalborg University Hospital, Denmark), the lead author of the study, commented: “Our results indicate that statins may have an important place in the prevention of bloodstream infection caused by S. aureus, which would hold important clinical and public health complications. Nevertheless, our observations warrant confirmation in other settings and the biological mechanisms by which statin treatment may protect against this type of infection should be explored further.”

Daniel DeSimone (Mayo Clinic, MN, USA) and Christopher DeSimone (Mayo Clinic) recently published an editorial in Mayo Clinic Proceedings that provides further insight into the research conducted by Smit and colleagues. The authors stated: “The work by Smit et al. raises the exciting possibility that the pleiotropic effects of statins may also harbor important antimicrobial effects that may exert a clinically relevant benefit by conferring resistance to CA-SAB.”

To conclude, DeSimone and DeSimone commented: “Based on the extensive research in this field, and now this study, we believe that the use of non-traditional antibiotic options such as statins to prevent and/or treat S. aureus bacteremia should be considered and further studied, especially in light of mounting antimicrobial resistance, the incidence of Clostridium difficile, and associated healthcare costs.”

Sources: Smit J, López-Cortés LE, Thomsen RW et al. Statin use and risk of community-acquired Staphylococcus aureus bacteremia. Mayo Clin. Proc. 92(10), 1469-1478 (2017); DeSimone DC, DeSimone CV. Beyond vasoprotection: statins and risk reduction for community-acquired Staphylococcus aureus bacteremia. Mayo Clin. Proc. 92(10), 1463-1465 (2017); www.eurekalert.org/pub_releases/2017-10/e-sua100217.php

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