Statins shown to reduce risk of potentially fatal bacterial infection in older patients

Heart patients on a regular regimen of statins have an almost 30 percent decreased risk of contracting a dangerous bacterium that can result in mortality, morbidity and serious metastatic infections, according to a study published in Mayo Clinic Proceedings.

Lead study author Jesper Smit, MD, PhD, and colleagues investigated the risk of community-contracted infection of Staphylococcus aureus bacteremia (CA-SAB) in thousands of patients in Europe, eventually finding that the higher the dose of statin medication, the less chance a patient had of contracting the infection. This was especially true in older patients with preexisting chronic conditions like diabetes, kidney disease and liver disease, Smit and co-authors wrote.

“Population-based studies have consistently identified male, diabetic and elderly individuals and those who require dialysis as patients at increased risk for S. aureus infections,” doctors Daniel C. DeSimone, MD, and Christopher V. DeSimone, MD, PhD, wrote in an editorial accompanying Smit’s study. “The development of antibiotic resistance, particularly methicillin-resistant S. aureus, occurs worldwide and is associated with increased mortality, greater durations of hospital stay and increased costs to the healthcare system.”

According to a 2015 study published in BMC Infectious Diseases, CA-SAB is one of the most common and lethal causes of bloodstream infection worldwide. In an infected population, 30-day all-cause mortality rates were as high as 39 percent, the researchers wrote, likely due to CA-SAB’s attraction to foreign objects, its ability to quickly develop resistance to antibiotics and its affinity for generating complex diseases.

The researchers used a large-cohort approach to analyze the medical data of close to 30,000 patients in Denmark and Spain over a 12-year period. Of the 2,638 individuals who were identified as having contracted CA-SAB, 14 percent were current statin users. Twelve percent of patients in the matched control group of 26,379 were using statin medications at the time.

Smit and co-authors took duration of current or former statin use, 90-day cumulative dosages and patient subgroups—diabetics, patients who’d had heart attacks in the past and those with kidney disease or other chronic conditions—into account while evaluating their data. They found that with increasing statin dosage, the risk for contracting CA-SAB gradually declined.

In patients who were current statin users, the risk was lowered by 27 percent. In long-term statin users, that number was as high as 30 percent, while new users saw a 4 percent decrease.

“S. aureus bacteremia has devastating consequences in those afflicted,” Christopher and Daniel DeSimone wrote. “Although there is a range of treatment options for S. aureus bacteremia, preventing its occurrence in the first place is obviously preferred, especially in the sickest patients who in turn would have the most to gain from an agent with a relatively low adverse effect profile. 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.”