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.
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.
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.
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.
M. L. U. Hansen,
N. Mejer, None
A. R. Larsen, None
A. Petersen, None
T. Benfield, None