In the Journals

Obesity, diabetes increase risk for group A Streptococcus

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January 17, 2016

Recent findings published in Clinical Infectious Diseases showed that diabetes and obesity were associated with as much as a fivefold increased risk for invasive group A Streptococcus.

“We found diabetes to be a risk factor for [invasive group A Streptococcus (iGAS)] infections among all races and extreme obesity to be a risk factor for iGAS infections among whites,” Chris Van Beneden, MD, MPH, epidemiologist at the CDC, and colleagues wrote. “Understanding who is at increased risk for iGAS infections and poorer outcomes has implications for recognizing severe infections, administering timely and appropriate treatments and targeting public health prevention efforts.”

Obesity and diabetes are known risk factors for syndromes that previously were associated with iGAS, including sepsis, skin and soft tissue infections, pneumonia and bloodstream infections, according to the researchers. Only one previous case-control study found that diabetes increased the risk for iGAS, but it did not assess obesity as a risk factor, they said.

Van Beneden and colleagues examined 2,927 adult cases of iGAS from the Active Bacterial Core surveillance system from 2010 to 2012. The researchers studied the association between iGAS and obesity and diabetes after adjusting for age, gender, race and other underlying conditions. In addition, multivariable logistic regression was used to determine whether obesity and diabetes increased the risk for death due to iGAS.

They found that diabetes was associated with an increased risk of iGAS in all racial groups, with the adjusted RR ranging from 2.71 to 5.08. Grade 3 obesity — defined as a BMI greater than or equal to 40 — was associated with an increased risk for iGAS in whites (aRR = 3.47; 95% CI, 3-4.01). In addition, grade 3 obesity was associated with an increased risk for death due to iGAS (OR = 1.62; 95% CI = 1.01-2.61).

Vaccines against iGAS are being developed, but options for limiting the disease currently are limited, according to the researchers.

“These results, if confirmed, may help target vaccines to patients with diabetes or obesity should they become available,” Van Beneden and colleagues wrote. “However … more needs to be done to understand how obesity may impact outcomes — particularly whether different treatment regimens, such as altered antibiotic dosing, would improve prognoses.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.

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