Asthma and risk of non-respiratory tract infection: a population-based case–control study

Abstract

ObjectivesAsthmatics 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 bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.DesignThe study was designed as a population-based retrospective case–control study.SettingThis population-based study was conducted in Olmsted County, Minnesota.ParticipantsThe study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.Primary and secondary outcome measuresOnly community-acquired E coli BSI cases as the primary outcome was included. Asthma status as an exposure was ascertained by predetermined criteria. An adjusted OR and 95% CI for the association between asthma and risk of community-acquired E coli BSI was calculated using conditional logistic regression.ResultsOf 259 eligible cases, 179 (69%) were women and mean age was 61±22 years. Of the 259 cases 37 (14%) and 16 (6%) of 259 controls had a prior history of asthma (adjusted OR 2.74; 95% CI 1.11 to 6.76; p=0.029). The population attributable risk of asthma for community-acquired E coli BSI was 9%. Although not statistically significant, there was a borderline association between having a history of food allergy and increased risk of community-acquired E coli BSI (6% vs 2%; adjusted OR 3.51; 95% CI 0.94 to 13.11; p=0.062).ConclusionsBased on the findings of the current population-based, case–control investigation, a history of asthma may be associated with risk of community-acquired E coli BSI. The impact of asthma on risk of microbial infections may go beyond airways.

Neonatal urinary tract infection may increase the risk of childhood asthma

“…Previous studies have reported that impaired innate immune factors may predispose to infection, particularly rhinovirus, Streptococcus pneumoniae, Salmonella enteritidis, and Escherichia coli [19,20]. The mechanism in effect indicates that allergic sensitization can induce similar impairment of innate immunity through toll-like receptor signal transduction.…”

Risks for infection in patients with asthma (or other atopic conditions): Is asthma more than a chronic airway disease?

“…78 We recently reported the association between asthma and an increased risk of community-acquired E coli BSI in a population-based case-control study (adjusted OR, 2.74; 95% CI, 1.11-6.76; P =.03). 52 Food allergy only approached statistical significance for the association (adjusted OR, 3.51; 95% CI, 0.94-13.1; p =.06), and other atopic conditions were not associated. In our study, there was no evidence of a differential asthma effect across age strata.…”

“…51 Recently, a population-based epidemiologic study showed a significantly increased risk of community-acquired Escherichia coli bloodstream infection (BSI) in persons with asthma compared with those without asthma (discussed in the next section). 52 …”

What Does Tympanostomy Tube Placement in Children Teach Us About the Association Between Atopic Conditions and Otitis Media?

“…Another study reported that oral corticosteroid therapy among patients using vitamin D resulted in a reduced risk of pneumonia. 71 Also, it has been found that ICS does not account for the association of atopic conditions with risks of various microbial infections 577273,7475,7656 Systemic corticosteroid therapy does not influence humoral or cell-mediated responses to vaccines or increase the risk of clinical infection. 77-81 …”