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Clinical impact of metformin exposure during Staphylococcus aureus bacteremia in patients with diabetes mellitus

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Abstract

Purpose

Increasing evidence has suggested that metformin may play positive roles in a wide range of infectious diseases. This study aimed to investigate the clinical impact of metformin exposure during Staphylococcus aureus bacteremia (SAB) in patients with diabetes.

Methods

A 3-year observational cohort study of 452 patients (aged ≥ 16 years) with SAB was performed at a tertiary care hospital. Metformin exposure was defined as receiving metformin during SAB, regardless of metformin use before the onset of bacteremia.

Results

Of 452 patients, 51 (11.3%) were classified in Group A (diabetes with metformin exposure), 115 (25.4%) in Group B (diabetes without metformin exposure), and 286 (63.3%) in Group C (no diabetes). The 30-day mortality rate in Group A was significantly lower than that in Group B (3.9% [2/51] versus 14.8% [17/115]; p = 0.04) and lower than that in Group C (3.9% [2/51] versus 17.1% [49/286]; p = 0.02). The mortality rates did not differ between Group B and Group C (14.8% [17/115] versus 17.1% [49/286]; p = 0.57). The rates of persistent and recurrent bacteremia were comparable among the three groups. Multivariate analysis indicated that metformin exposure was significantly associated with reduced mortality (adjusted odds ratio, 0.20; 95% confidence interval, 0.04–0.88; p = 0.03).

Conclusions

Metformin exposure during SAB appears to be an independent predictor of survival in patients with diabetes.

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Data availability

The datasets generated during the current study are not publicly available as they contain health related data but limited datasets (without any identifiable, person-related data) are available from the corresponding author upon reasonable request.

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Funding

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HV22C1234). The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

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Authors and Affiliations

  1. Department of Internal Medicine, Sam Anyang Hospital, Anyang, Republic of Korea

    Ju Young Lee

  2. Center for Antimicrobial Resistance and Microbial Genetics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Eun Sil Kim, Seongman Bae & Yang Soo Kim

  3. Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Eun Sil Kim, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Sang-Ho Choi, Sang-Oh Lee & Yang Soo Kim

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  1. Ju Young Lee
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Contributions

This study was conceived and designed by JYL and YSK. JYL, ESK, EC, SB, and JJ acquired the data. YJL, MJK, and YPC analysed and interpreted the data. The study was supervised by SHK, SHC, SOL, and YSK. YJL drafted the article, which was critically revised by SHK, SHC, SOL, and YSK.

Corresponding author

Correspondence to Yang Soo Kim.

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Ethical approval

The study was approved by the Asan Medical Center Institutional Review Board.

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All authors gave their consent for publication.

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There are no potential conflicts of interest for any authors.

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Lee, J.Y., Kim, E.S., Chang, E. et al. Clinical impact of metformin exposure during Staphylococcus aureus bacteremia in patients with diabetes mellitus. Eur J Clin Microbiol Infect Dis 42, 1439–1447 (2023). https://doi.org/10.1007/s10096-023-04679-6

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  • DOI: https://doi.org/10.1007/s10096-023-04679-6

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