Individuals hospitalized with acute mania have increased exposure to antimicrobial medications
Objectives We have preciously documented that many individuals with acute mania have immune activation. However, the sources of immune activation have not been identified. We investigated whether individuals hospitalized with acute mania have evidence of bacterial infections as determined by the pre...
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| Veröffentlicht in: | Bipolar disorders 2016-08, Vol.18 (5), p.404-409 |
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| creator | Yolken, Robert Adamos, Maria Katsafanas, Emily Khushalani, Sunil Origoni, Andrea Savage, Christina Schweinfurth, Lucy Stallings, Cassie Sweeney, Kevin Dickerson, Faith |
| description | Objectives
We have preciously documented that many individuals with acute mania have immune activation. However, the sources of immune activation have not been identified. We investigated whether individuals hospitalized with acute mania have evidence of bacterial infections as determined by the prescription of systemic antimicrobial agents.
Methods
We assessed the recent prescription of systemic antimicrobial medications and the site of presumed bacterial infection in 234 individuals hospitalized for acute mania in either an inpatient unit or a day hospital. We also assessed individuals hospitalized for other psychiatric disorders (n=368) and controls (n=555). We employed logistic regression models to compare the rates of antibiotic prescription in individuals with the different diagnoses, employing demographic variables as covariates.
Results
We found that individuals hospitalized with acute mania had a substantially increased rate of recent antimicrobial prescription, defined as exposure within three days of ascertainment (adjusted odds ratio=5.5, 95% confidence interval: 2.2–14.1, P |
| doi_str_mv | 10.1111/bdi.12416 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5508736</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1819142440</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4866-251204a540f401755dfbd6ae7c9fd9164a74209284dfb220c7465d41298da0803</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhiNERT_gwB9APsIhre34I7kg0ULblaoWEAjEAWs2dtiBJF5sZ9vy63G77QoOSPjikd5n3hn7LYqnjO6zfA7mFvcZF0w9KHZY1TSlVKx-eFvXuRZ6u9iN8TulTHEqHxXbXAsuZaN3iq-z0eIK7QR9JAsfl5igx1_OkktMCwLtlBwZYEQgC1g5gmMbHMSsu6ulj1NwJHkCY8IB2-DnCD0ZnMUWEvoxPi62uuzsntzde8XH4zcfjk7Ls4uT2dGrs7IVtVIll4xTAVLQTlCmpbTd3Cpwum062zAlIC9MG16LLHBOWy2UtILxprZAa1rtFS_Xvstpnse3bkwBerMMOEC4Nh7Q_K2MuDDf_MpISWtdqWzw_M4g-J-Ti8kMGFvX9zA6P0XDatYwwYWg_4MKpRireEZfrNH8NTEG1202YtTcRGdydOY2usw--_MJG_I-qwwcrIFL7N31v53M4evZvWW57sCY3NWmA8IPo3Slpfl0fmK-0ON3bzV7bz5XvwGv27Mq</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1814661132</pqid></control><display><type>article</type><title>Individuals hospitalized with acute mania have increased exposure to antimicrobial medications</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Yolken, Robert ; Adamos, Maria ; Katsafanas, Emily ; Khushalani, Sunil ; Origoni, Andrea ; Savage, Christina ; Schweinfurth, Lucy ; Stallings, Cassie ; Sweeney, Kevin ; Dickerson, Faith</creator><creatorcontrib>Yolken, Robert ; Adamos, Maria ; Katsafanas, Emily ; Khushalani, Sunil ; Origoni, Andrea ; Savage, Christina ; Schweinfurth, Lucy ; Stallings, Cassie ; Sweeney, Kevin ; Dickerson, Faith</creatorcontrib><description>Objectives
We have preciously documented that many individuals with acute mania have immune activation. However, the sources of immune activation have not been identified. We investigated whether individuals hospitalized with acute mania have evidence of bacterial infections as determined by the prescription of systemic antimicrobial agents.
Methods
We assessed the recent prescription of systemic antimicrobial medications and the site of presumed bacterial infection in 234 individuals hospitalized for acute mania in either an inpatient unit or a day hospital. We also assessed individuals hospitalized for other psychiatric disorders (n=368) and controls (n=555). We employed logistic regression models to compare the rates of antibiotic prescription in individuals with the different diagnoses, employing demographic variables as covariates.
Results
We found that individuals hospitalized with acute mania had a substantially increased rate of recent antimicrobial prescription, defined as exposure within three days of ascertainment (adjusted odds ratio=5.5, 95% confidence interval: 2.2–14.1, P<.0002). Overall, a total of 18 of the 234 (7.7%) individuals hospitalized for acute mania were prescribed antibiotics as opposed to seven of 555 (1.3%) controls. The prescription of antibiotics was associated with being on an inpatient unit as opposed to being in the day hospital, and having increased mania symptom severity but not with other clinical ratings, demographic variables, or psychiatric medications. Hospitalization for other psychiatric disorders was not associated with the recent prescription of antimicrobial medications. The urinary tract was the most common site of infection in women, while the respiratory tract and mucosal surfaces were the most common sites in men.
Conclusions
Individuals hospitalized with acute mania have a markedly increased rate of bacterial infections, as evidenced by the recent prescription of antimicrobial agents. The prevention and effective treatment of bacterial infections may be important interventions for the management of individuals with mania.
Editor Highlight: Previous studies have shown that many individuals hospitalized for episodes of mania have evidence of immune activation; however, the source of the immune activation has not been previously identified. The authors found that individuals hospitalized for mania had a significantly increased rate of recent bacterial infections compared to controls and individuals hospitalized for other psychiatric disorders as evidenced by their receipt of antimicrobial medications. The control of infections and antimicrobial therapy should be explored as means to prevent episodes of mania</description><identifier>ISSN: 1398-5647</identifier><identifier>EISSN: 1399-5618</identifier><identifier>DOI: 10.1111/bdi.12416</identifier><identifier>PMID: 27425597</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Adult ; Anti-Infective Agents - therapeutic use ; antibiotic ; Bacterial Infections - complications ; Bacterial Infections - diagnosis ; Bacterial Infections - drug therapy ; Bacterial Infections - immunology ; Bipolar Disorder - diagnosis ; Bipolar Disorder - etiology ; Bipolar Disorder - immunology ; Bipolar Disorder - therapy ; Female ; Hospitalization - statistics & numerical data ; Humans ; infection ; inflammation ; Logistic Models ; Male ; mania ; Middle Aged ; Prescription Drugs - therapeutic use ; Psychiatric Status Rating Scales ; Statistics as Topic ; Treatment Outcome</subject><ispartof>Bipolar disorders, 2016-08, Vol.18 (5), p.404-409</ispartof><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4866-251204a540f401755dfbd6ae7c9fd9164a74209284dfb220c7465d41298da0803</citedby><cites>FETCH-LOGICAL-c4866-251204a540f401755dfbd6ae7c9fd9164a74209284dfb220c7465d41298da0803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbdi.12416$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbdi.12416$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27425597$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yolken, Robert</creatorcontrib><creatorcontrib>Adamos, Maria</creatorcontrib><creatorcontrib>Katsafanas, Emily</creatorcontrib><creatorcontrib>Khushalani, Sunil</creatorcontrib><creatorcontrib>Origoni, Andrea</creatorcontrib><creatorcontrib>Savage, Christina</creatorcontrib><creatorcontrib>Schweinfurth, Lucy</creatorcontrib><creatorcontrib>Stallings, Cassie</creatorcontrib><creatorcontrib>Sweeney, Kevin</creatorcontrib><creatorcontrib>Dickerson, Faith</creatorcontrib><title>Individuals hospitalized with acute mania have increased exposure to antimicrobial medications</title><title>Bipolar disorders</title><addtitle>Bipolar Disord</addtitle><description>Objectives
We have preciously documented that many individuals with acute mania have immune activation. However, the sources of immune activation have not been identified. We investigated whether individuals hospitalized with acute mania have evidence of bacterial infections as determined by the prescription of systemic antimicrobial agents.
Methods
We assessed the recent prescription of systemic antimicrobial medications and the site of presumed bacterial infection in 234 individuals hospitalized for acute mania in either an inpatient unit or a day hospital. We also assessed individuals hospitalized for other psychiatric disorders (n=368) and controls (n=555). We employed logistic regression models to compare the rates of antibiotic prescription in individuals with the different diagnoses, employing demographic variables as covariates.
Results
We found that individuals hospitalized with acute mania had a substantially increased rate of recent antimicrobial prescription, defined as exposure within three days of ascertainment (adjusted odds ratio=5.5, 95% confidence interval: 2.2–14.1, P<.0002). Overall, a total of 18 of the 234 (7.7%) individuals hospitalized for acute mania were prescribed antibiotics as opposed to seven of 555 (1.3%) controls. The prescription of antibiotics was associated with being on an inpatient unit as opposed to being in the day hospital, and having increased mania symptom severity but not with other clinical ratings, demographic variables, or psychiatric medications. Hospitalization for other psychiatric disorders was not associated with the recent prescription of antimicrobial medications. The urinary tract was the most common site of infection in women, while the respiratory tract and mucosal surfaces were the most common sites in men.
Conclusions
Individuals hospitalized with acute mania have a markedly increased rate of bacterial infections, as evidenced by the recent prescription of antimicrobial agents. The prevention and effective treatment of bacterial infections may be important interventions for the management of individuals with mania.
Editor Highlight: Previous studies have shown that many individuals hospitalized for episodes of mania have evidence of immune activation; however, the source of the immune activation has not been previously identified. The authors found that individuals hospitalized for mania had a significantly increased rate of recent bacterial infections compared to controls and individuals hospitalized for other psychiatric disorders as evidenced by their receipt of antimicrobial medications. The control of infections and antimicrobial therapy should be explored as means to prevent episodes of mania</description><subject>Adult</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>antibiotic</subject><subject>Bacterial Infections - complications</subject><subject>Bacterial Infections - diagnosis</subject><subject>Bacterial Infections - drug therapy</subject><subject>Bacterial Infections - immunology</subject><subject>Bipolar Disorder - diagnosis</subject><subject>Bipolar Disorder - etiology</subject><subject>Bipolar Disorder - immunology</subject><subject>Bipolar Disorder - therapy</subject><subject>Female</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>infection</subject><subject>inflammation</subject><subject>Logistic Models</subject><subject>Male</subject><subject>mania</subject><subject>Middle Aged</subject><subject>Prescription Drugs - therapeutic use</subject><subject>Psychiatric Status Rating Scales</subject><subject>Statistics as Topic</subject><subject>Treatment Outcome</subject><issn>1398-5647</issn><issn>1399-5618</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1v1DAQhiNERT_gwB9APsIhre34I7kg0ULblaoWEAjEAWs2dtiBJF5sZ9vy63G77QoOSPjikd5n3hn7LYqnjO6zfA7mFvcZF0w9KHZY1TSlVKx-eFvXuRZ6u9iN8TulTHEqHxXbXAsuZaN3iq-z0eIK7QR9JAsfl5igx1_OkktMCwLtlBwZYEQgC1g5gmMbHMSsu6ulj1NwJHkCY8IB2-DnCD0ZnMUWEvoxPi62uuzsntzde8XH4zcfjk7Ls4uT2dGrs7IVtVIll4xTAVLQTlCmpbTd3Cpwum062zAlIC9MG16LLHBOWy2UtILxprZAa1rtFS_Xvstpnse3bkwBerMMOEC4Nh7Q_K2MuDDf_MpISWtdqWzw_M4g-J-Ti8kMGFvX9zA6P0XDatYwwYWg_4MKpRireEZfrNH8NTEG1202YtTcRGdydOY2usw--_MJG_I-qwwcrIFL7N31v53M4evZvWW57sCY3NWmA8IPo3Slpfl0fmK-0ON3bzV7bz5XvwGv27Mq</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>Yolken, Robert</creator><creator>Adamos, Maria</creator><creator>Katsafanas, Emily</creator><creator>Khushalani, Sunil</creator><creator>Origoni, Andrea</creator><creator>Savage, Christina</creator><creator>Schweinfurth, Lucy</creator><creator>Stallings, Cassie</creator><creator>Sweeney, Kevin</creator><creator>Dickerson, Faith</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QL</scope><scope>7TK</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>201608</creationdate><title>Individuals hospitalized with acute mania have increased exposure to antimicrobial medications</title><author>Yolken, Robert ; Adamos, Maria ; Katsafanas, Emily ; Khushalani, Sunil ; Origoni, Andrea ; Savage, Christina ; Schweinfurth, Lucy ; Stallings, Cassie ; Sweeney, Kevin ; Dickerson, Faith</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4866-251204a540f401755dfbd6ae7c9fd9164a74209284dfb220c7465d41298da0803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>antibiotic</topic><topic>Bacterial Infections - complications</topic><topic>Bacterial Infections - diagnosis</topic><topic>Bacterial Infections - drug therapy</topic><topic>Bacterial Infections - immunology</topic><topic>Bipolar Disorder - diagnosis</topic><topic>Bipolar Disorder - etiology</topic><topic>Bipolar Disorder - immunology</topic><topic>Bipolar Disorder - therapy</topic><topic>Female</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>infection</topic><topic>inflammation</topic><topic>Logistic Models</topic><topic>Male</topic><topic>mania</topic><topic>Middle Aged</topic><topic>Prescription Drugs - therapeutic use</topic><topic>Psychiatric Status Rating Scales</topic><topic>Statistics as Topic</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yolken, Robert</creatorcontrib><creatorcontrib>Adamos, Maria</creatorcontrib><creatorcontrib>Katsafanas, Emily</creatorcontrib><creatorcontrib>Khushalani, Sunil</creatorcontrib><creatorcontrib>Origoni, Andrea</creatorcontrib><creatorcontrib>Savage, Christina</creatorcontrib><creatorcontrib>Schweinfurth, Lucy</creatorcontrib><creatorcontrib>Stallings, Cassie</creatorcontrib><creatorcontrib>Sweeney, Kevin</creatorcontrib><creatorcontrib>Dickerson, Faith</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Neurosciences Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Bipolar disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yolken, Robert</au><au>Adamos, Maria</au><au>Katsafanas, Emily</au><au>Khushalani, Sunil</au><au>Origoni, Andrea</au><au>Savage, Christina</au><au>Schweinfurth, Lucy</au><au>Stallings, Cassie</au><au>Sweeney, Kevin</au><au>Dickerson, Faith</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Individuals hospitalized with acute mania have increased exposure to antimicrobial medications</atitle><jtitle>Bipolar disorders</jtitle><addtitle>Bipolar Disord</addtitle><date>2016-08</date><risdate>2016</risdate><volume>18</volume><issue>5</issue><spage>404</spage><epage>409</epage><pages>404-409</pages><issn>1398-5647</issn><eissn>1399-5618</eissn><abstract>Objectives
We have preciously documented that many individuals with acute mania have immune activation. However, the sources of immune activation have not been identified. We investigated whether individuals hospitalized with acute mania have evidence of bacterial infections as determined by the prescription of systemic antimicrobial agents.
Methods
We assessed the recent prescription of systemic antimicrobial medications and the site of presumed bacterial infection in 234 individuals hospitalized for acute mania in either an inpatient unit or a day hospital. We also assessed individuals hospitalized for other psychiatric disorders (n=368) and controls (n=555). We employed logistic regression models to compare the rates of antibiotic prescription in individuals with the different diagnoses, employing demographic variables as covariates.
Results
We found that individuals hospitalized with acute mania had a substantially increased rate of recent antimicrobial prescription, defined as exposure within three days of ascertainment (adjusted odds ratio=5.5, 95% confidence interval: 2.2–14.1, P<.0002). Overall, a total of 18 of the 234 (7.7%) individuals hospitalized for acute mania were prescribed antibiotics as opposed to seven of 555 (1.3%) controls. The prescription of antibiotics was associated with being on an inpatient unit as opposed to being in the day hospital, and having increased mania symptom severity but not with other clinical ratings, demographic variables, or psychiatric medications. Hospitalization for other psychiatric disorders was not associated with the recent prescription of antimicrobial medications. The urinary tract was the most common site of infection in women, while the respiratory tract and mucosal surfaces were the most common sites in men.
Conclusions
Individuals hospitalized with acute mania have a markedly increased rate of bacterial infections, as evidenced by the recent prescription of antimicrobial agents. The prevention and effective treatment of bacterial infections may be important interventions for the management of individuals with mania.
Editor Highlight: Previous studies have shown that many individuals hospitalized for episodes of mania have evidence of immune activation; however, the source of the immune activation has not been previously identified. The authors found that individuals hospitalized for mania had a significantly increased rate of recent bacterial infections compared to controls and individuals hospitalized for other psychiatric disorders as evidenced by their receipt of antimicrobial medications. The control of infections and antimicrobial therapy should be explored as means to prevent episodes of mania</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>27425597</pmid><doi>10.1111/bdi.12416</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Bipolar disorders, 2016-08, Vol.18 (5), p.404-409 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adult Anti-Infective Agents - therapeutic use antibiotic Bacterial Infections - complications Bacterial Infections - diagnosis Bacterial Infections - drug therapy Bacterial Infections - immunology Bipolar Disorder - diagnosis Bipolar Disorder - etiology Bipolar Disorder - immunology Bipolar Disorder - therapy Female Hospitalization - statistics & numerical data Humans infection inflammation Logistic Models Male mania Middle Aged Prescription Drugs - therapeutic use Psychiatric Status Rating Scales Statistics as Topic Treatment Outcome |
| title | Individuals hospitalized with acute mania have increased exposure to antimicrobial medications |
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