The associations between socioeconomic status and risk of Staphylococcus aureus bacteremia and subsequent endocarditis – a Danish nationwide cohort study

BMC Infectious Diseases

Research Article

Michelle D. Schmiegelow¹  Niels Eske Bruun²  Andreas Petersen³  Robert L. Skov³  Paal Skytt Andersen³  Christian Torp-Pedersen⁴  Louise Bruun Oestergaard⁵ 

[1] Department of Cardiology, Copenhagen University Hospital, Gentofte; Kildegaards Vej 28, Post-635, 2900, Hellerup, Denmark;Department of Cardiology, Copenhagen University Hospital, Gentofte; Kildegaards Vej 28, Post-635, 2900, Hellerup, Denmark;Clinical Institute, Aalborg University, Aalborg, Denmark;The Department of Microbiology and Infection Control, Statens Serum Institut (SSI), Copenhagen, Denmark;The Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark;The Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark;Department of Cardiology, Copenhagen University Hospital, Gentofte; Kildegaards Vej 28, Post-635, 2900, Hellerup, Denmark;

关键词: Staphylococcus aureus;    Social status;    Young adults;    Endocarditis;    Risk factors;    Education;   

DOI  :  10.1186/s12879-017-2691-3

 received in 2017-05-09, accepted in 2017-08-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundStaphylococcus aureus bacteremia (SAB) is the leading cause of infective endocarditis in several countries. Since socioeconomic status (SES) is known to influence the risk of infectious diseases in general, we aimed to investigate the association between SES and SAB, and risk of subsequent endocarditis in a nationwide adult population.MethodsAll Danish residents were consecutively included at age ≥ 30 years during 1996–2010. We obtained information on SES (highest attained educational level), comorbidities, and microbiologically verified SAB by cross-linking nationwide registries. The incidence rate ratios (IRRs) of SAB and later endocarditis were investigated using Poisson regression models adjusted for sex, age and year (reference = highest SES).ResultsOur study population comprised 3,394,936 individuals (median age = 43.2 years). Over a median follow-up of 15.9 years, 13,181 individuals acquired SAB. SES was inversely associated with SAB acquisition, which declined with increasing age, e.g. in individuals with lowest SES, IRRs were 3.78 (95% confidence interval [CI] = 2.89–4.95) in age 30–50 years, 1.87 (CI = 1.60–2.18) in age > 50–70 years and 1.31 (CI = 1.11–1.54) in age > 70 years (interaction-p < 0.0001). Adjustment for comorbidities attenuated the IRRs, but the pattern persisted. No association between SES and endocarditis risk among patients with SAB was observed.ConclusionsDecreasing SES was associated with an increased risk of SAB, particularly in younger adults. SES was not associated with risk of subsequent endocarditis.

【 授权许可】

CC BY   
© The Author(s). 2017