287. Increased Risk of Incident Diabetes Mellitus 2 Years after Staphylococcus aureus Bacteremia. A Matched Cohort Study
Session: Poster Abstract Session: HAI: MSSA, MRSA, and other Gram-Positives
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • ML_6_oktober_ID_WEEK.pdf (476.4 kB)
  • Background:

    Diabetes mellitus (DM) is a known risk factor for infection with Staphylococcus aureus and consequently S. aureus may be an indicator of unrecognized DM. We hypothesize that S. aureus bacteremia (SAB) also may be an indicator of prediabetes and thereby signify an increased risk of DM following SAB. We investigated the incidence of DM in hospitalized patients with SAB compared to population controls.

    Methods:

    Nationwide population-based matched cohort study. Cases of DM were ascertained through the National Discharge Registry and the National Diabetes Registry. Cases with DM prior to SAB admission were excluded including their controls. Incidence rate (IR) and ratio (IRR) with 95% confidence interval (CI) was estimated by Poisson regression. All analyses were adjusted for age, sex, comorbidity, hospital contact and time period.

    Results:

    Of 19,988 individuals with SAB and 185,579 population controls, 432 (2.2%) and 2033 (1.1%) were diagnosed with DM within 2 years after discharge of SAB, respectively. The corresponding IRs were 3.90 (95% CI: 3.23-4.71) and 2.23 (95% CI: 1.90-2.63) per 1000 person-years. Cases had an overall higher risk of DM within 2 years (IRR: 1.75 (95% CI: 1.56-1.95). The risk of DM was highest immediately in the first 90 days (IRR: 3.75 (95% CI: 2.96-4.74)) and 91-180 days (IRR: 2.17 (95% CI: 1.32-3.58)). Particularly, the risk of DM with complications was high 180 days after SAB (IRR: 9.84 (95% CI: 6.51-14.87)). Between 2 and 5 years after SAB, cases were less likely to be diagnosed with DM than controls were (IRR: 0.71 (95% CI: 0.62-0.82)). The number needed to screen in order to detect one case of DM was 125 within the first year and 91 within two years of SAB.

    Conclusion:

    The risk of DM was markedly increased up to 2 years after SAB compared to population controls. In addition to screening for DM during admittance, we suggest that screening cases of SAB for DM in the 2 years following SAB may allow for earlier detection of DM and prevention of further disease progression.

    Figure 1. Elevated cumulative incidence for diabetes mellitus following Staphylococcus aureus bacteremia 2 years after SAB discharge.

     

    Marie-Louise Uhre Hansen, BM1, Nanja Gotland, BM1, Niels Mejer, MSc, PhD2, Anders Rhod Larsen, PhD3, Andreas Petersen, MSc, PhD4 and Thomas Benfield, MD, DMSc5, (1)Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark, (2)Hvidovre University Hospital, Hvidovre, Denmark, (3)Statens Serum Institut, Copenhagen, Denmark, (4)Statens Serum Institut, copenhagen, Denmark, (5)Department of Infectious Disease, Hvidovre University Hospital, Hvidovre, Denmark

    Disclosures:

    M. L. U. Hansen, None

    N. Gotland, None

    N. Mejer, None

    A. R. Larsen, None

    A. Petersen, None

    T. Benfield, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.