title: Association between vitamin D deficiency and methicillin-resistant Staphylococcus aureus infection.
abstract: OBJECTIVE
  Given that vitamin D (25(OH)D) contributes to immune defense, we sought to determine if deficiency of 25(OH)D was significantly associated with methicillin-resistant Staphylococcus aureus (MRSA) infection.
  
  
  METHODS
  All patients with 25(OH)D determinations at the Atlanta VAMC from 2007 to 2010 were included in the analyses. These patients were cross-referenced with a prospectively collected MRSA infection database at the AVAMC (2006-2010). Patients with one or more MRSA infections during the study period were considered MRSA-infected patients. Multivariate logistic regression was used to determine the association between 25(OH)D status [deficient (<20 ng/mL) vs. non-deficient (≥20 ng/mL)] and MRSA infection.
  
  
  RESULTS
  A total of 6405 patients with 25(OH)D determinations were included in the analyses, of which 401 (6.3 %) were MRSA-infected patients. Mean (SD) vitamin D levels, in ng/mL, were 21.1 (12.4) and 24.0 (12.6) for MRSA-infected patients and non-MRSA infected patients, respectively (p < 0.0001). The multivariate logistic regression model confirmed associations between MRSA infection and sex, race, BMI, HIV status, and 25(OH)D [odds ratio for 25(OH)D: 1.94; 95 % confidence interval: 1.51-2.49].
  
  
  CONCLUSIONS
  MRSA-infected patients had significantly lower serum vitamin D levels than non-MRSA infected patients, even when controlling for potential confounding variables.
authors.affiliation: University of Washington Internal Medicine Residency Program, Harborview Medical Center, Box 359892, 325 9th Ave, Seattle, WA, 98104, USA. Jennalthomason@gmail.com.
authors.forename: Jenna
authors.initials: J
authors.lastname: Thomason
authors.affiliation: Atlanta Veterans' Affairs Medical Center, Emory University School of Medicine, 1670 Clairmont Road (111-RIM), Decatur, GA, 30033, USA. Christopher.Rentsch@va.gov.
authors.forename: Christopher
authors.initials: C
authors.lastname: Rentsch
authors.affiliation: Intermountain Medical Center, 5121 S. Cottonwood Street, Gardner Women and Newborn Center, LL2, Murray, UT, 84157, USA. e.stenehjem@gmail.com.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Stenehjem
authors.affiliation: Universidad Pontificia Bolivariana, Hospital Pablo Tobón Uribe, Emory University School of Medicine, Calle 78B # 69-240, Medellín, Colombia. aliciahidron@gmail.com.
authors.forename: Alicia I
authors.initials: AI
authors.lastname: Hidron
authors.affiliation: Atlanta Veterans' Affairs Medical Center, Emory University School of Medicine, 1670 Clairmont Road (111-RIM), Decatur, GA, 30033, USA. david.rimland@va.gov.
authors.forename: David
authors.initials: D
authors.lastname: Rimland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D014808:Vitamin D Deficiency / Q000150:complications*
keywords: MRSA infection; Staphyloccoccus aureus; Veteran population; Vitamin D deficiency