Universität zu Köln

Smit, Jesper, Kaasch, Achim J., Sogaard, Mette ORCID: 0000-0002-2830-4968, Thomsen, Reimar W., Nielsen, Henrik, Froslev, Trine and Schonheyder, Henrik C. (2016). Use of Glucocorticoids and Risk of Community-Acquired Staphylococcus aureus Bacteremia: A Population-Based Case-Control Study. Mayo Clin. Proc., 91 (7). S. 873 - 881. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1942-5546

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Abstract

Objective: To investigate whether the use of systemic glucocorticoids is a risk factor for community-acquired Staphylococcus aureus bacteremia (CA-SAB). Patients and Methods: We used population-based medical registries in Northern Denmark to conduct a case-control study including all adults with first-time CA-SAB and matched population controls from January 1, 2000, through December 31, 2011. Glucocorticoid users were categorized as current users (new or long-term use), former users, and nonusers. Using conditional logistic regression, we computed odds ratios (ORs) of CA-SAB according to glucocorticoid exposure, overall and by 90-day prednisolone-equivalent cumulative dose. Results: We identified 2638 patients with first-time CA-SAB and 26,379 matched population controls. Current glucocorticoid users experienced considerably increased risk of CA-SAB compared with nonusers (adjusted OR = 2.48; 95% CI, 2.12-2.90). The adjusted OR was 2.73 (95% CI, 2.17-3.45) in new users, 2.31 (95% CI, 1.90-2.82) in long-term users, and much lower at 1.33 (95% CI, 0.98-1.81) in former users of glucocorticoids compared with nonusers. The risk of CA-SAB increased with higher 90-day cumulative doses. Compared with nonusers of glucocorticoids, the adjusted OR was 1.32 (95% CI, 1.01-1.72) for persons with a cumulative dose of 150 mg or less, 2.42 (95% CI, 1.76-3.33) for persons whose cumulative dose was greater than 500 to 1000 mg, and 6.25 (95% CI, 4.74-8.23) for persons with a cumulative dose greater than 1000 mg. Conclusion: Glucocorticoid use was associated with a substantially increased risk of CA-SAB. The risk increased with higher cumulative dose, revealing a distinct dose-response relation. (C) 2016 Mayo Foundation for Medical Education and Research

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Smit, Jesper UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaasch, Achim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sogaard, Mette UNSPECIFIED orcid.org/0000-0002-2830-4968 UNSPECIFIED Thomsen, Reimar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nielsen, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Froslev, Trine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schonheyder, Henrik C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-270845
DOI:	10.1016/j.mayocp.2016.04.023
Journal or Publication Title:	Mayo Clin. Proc.
Volume:	91
Number:	7
Page Range:	S. 873 - 881
Date:	2016
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1942-5546
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INFECTION; COMORBIDITY; MECHANISMS; NATIONWIDE Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27084