One of the many bad things that may happen to you in the hospital is a blood infection. It is assumed to be a hospital acquired infection because the blood cultures were positive more than 48 hours after the doctors hospitalized you, meaning it is unlikely you had the infection on admission.
Also called nosocomial infections, the most common nosocomial infections in descending order of frequency are catheter related urinary tract infections, surgical site infections, pneumonias, and hospital-acquired bloodstream infections (HABSIs). Although HABSIs account for only about 12% of all nosocomial infections, they account for a much greater share of length of stay, cost, and death than other nosocomial infection. The CDC estimates 1.7 million nosocomial infections occur every year in the US, with 99,000 deaths associated with those infections.
Associate Professor Sadeq Quraishi (who is a board member of the Vitamin D Council) and colleagues, working under senior author Doctor Kenneth Christopher, all of Harvard, may have found a way to cut those infections in half.
They studied more than 2,100 patients who had both a vitamin D level and a blood culture taken between the years 1993 and 2011. They were part of a larger cohort of 21,000 patients who were hospitalized and had a 25(OH)D level but not necessarily a blood culture.
Quraishi SA, Litonjua AA, Moromizato T, Gibbons FK, Camargo CA Jr, Giovannucci E, Christopher KB. Association between prehospital vitamin D status and hospital-acquired bloodstream infections. Am J Clin Nutr. 2013 Aug 14.
The authors found that, relative to all 21,000 hospitalized patients, the adjusted odds ratio (OR) of having an HABI was more than 3 if your 25(OH)D level was < 10 ng/ml, compared to those with 25(OH)D levels > 30 ng/ml ( P<0.0001). This means that if you were sufficient in vitamin D, you were three times less likely of getting an HABI compared to if you were severely deficient.
Compared to the 2,100 patients who had both a 25(OH)D levels and a blood culture, for 25(OH)D concentrations <10 ng/mL, the adjusted OR was 1.95; for 25(OH)D concentrations from 10 to 19.9 ng/mL, the OR was 1.36; and for 25(OH)D concentrations from 20 to 29.9 ng/mL, the OR was unchanged. However, as a continuous variable, the risk decreased all the way up to 40 ng/ml, but the real risk was in the < 20 ng/ml group.
The authors concluded,
“These data show that prehospital 25(OH)D concentrations <10 ng/mL are associated with increased odds of HABSI in a large cohort of hospitalized patients. Our work supports the hypothesis that better vitamin D status may play an important protective role against nosocomial infections. Although vitamin D supplementation may decrease the incidence of acute respiratory tract infections in ambulatory settings, we believe that our results provide clinical evidence of a potential link between vitamin D and outcomes of hospitalized patients. We illustrate the possibility that even small changes in vitamin D status may affect HABSI.”
And they recommend further research,
“Despite our observations, the supplementation of vitamin D in the hospitalized adult cannot currently be advocated solely for HABSI. Longitudinal studies are required to confirm our findings and to further investigate the mechanisms underlying these observations. If confirmed, randomized, placebo-controlled trials will be needed to determine whether vitamin D supplementation therapy before or at the time of hospital admission might have a benefit in improving outcomes in hospitalized patients.”
The authors dedicated their paper to their dear friend and colleague Nathan Edward Hellman, MD PhD, who tragically died at in 2010 at 37 years of age from a stroke.