title: Effect of statins on outcomes in immunosuppressed patients with bloodstream infection.
abstract: Although it has been suggested that statins have a beneficial effect on the outcome of bloodstream infection (BSI) in immunosuppressed patients, prospective studies testing this hypothesis are lacking. We performed an observational analysis of consecutive cancer patients and transplant recipients hospitalized at two tertiary hospitals in Spain (2006-2009). The first episode of BSI occurring in statin users was compared with those occurring in non-statin users. During the study period, 668 consecutive episodes of BSI in 476 immunosuppressed patients were recorded. Underlying diseases were solid tumor (46.2%), hematologic malignancy (35.1%), and transplantation (18.7%). Fifty-nine (12.4%) patients were receiving statins at the onset of BSI. Comparing with statin non-users, patients on statin treatment were older (67.3 vs. 58.7 years; p < 0.001) and had higher frequency of comorbidities (74.6% vs. 40.6%; p < 0.001). There were no significant differences in intensive care unit admission (6.8% vs. 7.7%; p = 1) and overall mortality (15.3% vs. 24%; p = 0.13) between groups. In a multivariate analysis, prior statin use was not associated with increased survival (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.22-1.23; p = 0.14). In conclusion, prior statin use is not associated with increased survival in immunosuppressed patients with BSI. Caution is warranted in attributing beneficial effects to statin use in infections among immunocompromised patients.
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain. dfviasusp@unal.edu.co
authors.forename: D
authors.initials: D
authors.lastname: Viasus
authors.forename: C
authors.initials: C
authors.lastname: Gudiol
authors.forename: N
authors.initials: N
authors.lastname: Fernández-Sabé
authors.forename: I
authors.initials: I
authors.lastname: Cabello
authors.forename: C
authors.initials: C
authors.lastname: Garcia-Vidal
authors.forename: M
authors.initials: M
authors.lastname: Cisnal
authors.forename: R
authors.initials: R
authors.lastname: Duarte
authors.forename: M
authors.initials: M
authors.lastname: Antonio
authors.forename: J
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality; D013030:Spain; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors