Asthma and Risk of Community-Acquired Blood Stream Infection Caused by Escherichia Coli: A Population-Based Case-Control Study

Abstract

M O N D A Y 537 Asthma and Risk of Community-Acquired Blood Stream Infection Caused by Escherichia Coli: A Population-Based Case-Control Study Hyeon Jong Jong Yang, MD, Duk Won Bang, Eell Ryoo, Larry Baddour, Majdi Al-Hasan, Barbara Yawn, MD, MSc, FAAFP, Young J. Juhn, MD, MPH; Soonchunhyang University Hospital, Seoul, Mayo Clinic, Gil Hospital, South Korea, University of Kentucky Medical Center, Olmsted Medical Center, Rochester, MN, Mayo Clinic, Rochester, MN. RATIONALE: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli blood stream infection (BSI). We assessed whether asthma status is associated with risk of developing community-acquired E.coli BSI. METHODS: The study was designed as a population-based retrospective case-control study, which enrolled 259 eligible communityacquired E. coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-, genderand residency-matched controls. We excluded nosocomial and health care-associated E. coli BSI cases and non-Olmsted County, MN residents. Asthma status was ascertained by predetermined criteria for asthma. Data were fitted to a conditional logistic regression model to calculate adjusted odds ratio and 95% confidence interval (CI). RESULTS: Of 259 eligible patients, 179 (69 %) were female and mean age was 61622 years. Thirty-six (14 %) of 259 cases and 16 (6 %) of 259 controls had a prior history of asthma (adjusted OR, 2.84; 95%CI, 1.14-7.09, p50.026) controlling for ethnicity, educational level, statistically significant comorbid conditions, and immunosuppressive therapy. Asthma severity was associated with risk of E. coli BSI (OR:0.94, 95% CI: 0.31-2.80 for intermittent asthma; OR 3.17; 95% CI, 1.15-8.75 for mild persistent asthma; and OR 7.0; 95%CI 1.59-30.80 for moderate persistent asthma) compared to non-asthmatics. Sixteen (6.2%) cases and 6 controls (2.3%) had food allergy (adjusted OR 3.24, 95%CI, 0.92-11.38, p50.067). CONCLUSIONS: The study results suggest that a history of asthma may be a risk factor associated with the development of E. coli BSI.