title: Case-control study of statin prevention of mould infections.
abstract: Invasive mould infections (IMI) are associated with significant morbidity and mortality. In vitro studies have demonstrated that hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors (statins) have activity against several pathogenic moulds including Zygomycetes and Aspergillus spp. The aim of our study was to determine if statin use is a preventive factor for the development of IMI. This was a retrospective case-control study of 10 United States Veterans Affairs Medical Centers that comprise the Veterans Integrated Service Network (VISN) 16. Cases with IMI and controls were identified from 2001 to 2008. Controls were matched by age, facility, history of transplantation, presence of chronic steroid use and presence of human immunodeficiency virus infection (HIV). Two hundred and thirty-eight patients were included. Independent variables associated with the development of IMI were history of solid malignant tumours (OR 2.63, 1.41-4.87) and hypertension (OR 2.29, 1.13-4.68). Statin use within 3 months of index date was not an independent variable for prevention or development of IMI. No level of exposure to a statin drug appeared to influence the development of infection. This retrospective case-control study suggests that despite evidence of in vitro activity, statins may not decrease risk of IMI. Prospective, controlled trials may be necessary to investigate any potential clinical benefit.
authors.affiliation: Oklahoma City VA Medical Center, Oklahoma City, OK 73104, USA.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Thompson
authors.forename: Mark M
authors.initials: MM
authors.lastname: Huycke
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Greenfield
authors.forename: George
authors.initials: G
authors.lastname: Kurdgelashvili
authors.forename: Chris A
authors.initials: CA
authors.lastname: Gentry
mesh_terms: D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D018890:Chemoprevention / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control*; D012189:Retrospective Studies; D014481:United States
chemical_list: D000924:Anticholesteremic Agents; D000935:Antifungal Agents