Vitamin D Deficiency a Risk Factor for MRSA Infection?

Thomas Glück, MD reviewing Thomason J et al. Infection 2015 Jul 4.

In a retrospective study involving Veterans Affairs patients in Atlanta, incidence of methicillin-resistant Staphylococcus aureus infections was nearly doubled among those with vitamin D deficiency.

Vitamin D's importance for bone health is well established. Recently, its roles in immunologic, neurologic, cardiovascular, and respiratory functions have been described. Several reports have suggested associations between vitamin D deficiency (VDD) and greater illness severity, poorer outcomes, and higher mortality risk.

Using data on serum 25-hydroxy vitamin D (25(OH)D) levels of patients treated at the Atlanta Veterans Affairs Medical Center between January 2007 and August 2010, Thomason and colleagues explored the potential association between VDD and methicillin-resistant Staphylococcus aureus (MRSA) infections. Of 6405 patients with at least one 25(OH)D determination during the study period (mean age, 64.2; 89% men, 50% black; 15% HIV-infected), 41% were 25(OH)D deficient (<20 ng/mL). VDD was significantly associated with younger age, HIV infection, measurement during winter, female sex, body-mass index (BMI), and black race.

In all, 401 of the patients experienced MRSA infections between October 2005 and December 2010 (range, 1–5 episodes; 70% with only 1). The infections occurred between 1360 days before and 1669 days after 25(OH)D measurement (median, 77 days after measurement). Skin and soft tissue were the most common infection sites (58%). In multivariate analysis, MRSA infection was significantly associated with male sex, lower BMI, HIV infection, and VDD. Patients with VDD were twice as likely as those with normal 25(OH)D levels to experience a MRSA infection (odds ratio, 1.94; 95% confidence interval, 1.5–2.5).

Citation(s):

Thomason J et al. Association between vitamin D deficiency and methicillin-resistant Staphylococcus aureus infection. Infection 2015 Jul 4; [e-pub].