Corticosteroids, rifampicin and LMWH impact plasma aMMP-8 and TIMP-1 and aMMP-8/TIMP-1 molar ratio in methicillin-sensitive Staphylococcus aureus bacteremia.

OBJECTIVES

Matrix metalloproteinase-8 (MMP-8) and tissue inhibitor of metalloproteinases-1 (TIMP-1) predict outcomes in Staphylococcus aureus bacteremia (SAB). However, the impact of medications on MMPs and their prognostic capability in SAB lacks evaluation.

METHODS

Prospective study with aMMP-8, TIMP-1, and aMMP-8/TIMP-1 determined in methicillin-sensitive SAB (MS-SAB). We evaluated the effect of the medications on MMPs.

RESULTS

Overall, 395 patients with MS-SAB received 21 different medications. Most medications did not affect MMPs. Prehospital corticosteroids elevated day 3 aMMP-8 and aMMP-8/TIMP-1 (P <0.01). In-hospital corticosteroids is associated with higher day 3 and 28 (P <0.01) aMMP-8 levels and higher day 3, 5, and 28 (P <0.01) aMMP-8/TIMP-1. Rifampicin elevated day 3, 5, and 28 aMMP-8 (P <0.01) and aMMP-8/TIMP-1 (P <0.05). Low-weight molecular heparin (LMWH) elevated day 3, 5, and 28 aMMP-8 and TIMP-1 (P <0.01) and day 5 and 28 aMMP-8/TIMP-1 (P < 0.05). A prognostic survival value of aMMP-8/TIMP-1 in Cox Regression was observed for patients treated with corticosteroids, rifampicin, or LMWH.

CONCLUSIONS

Corticosteroids, rifampicin, and LMWH may elevate aMMP-8 and aMMP-8/TIMP-1 levels in MS-SAB; however, the prognostic value of aMMP-8/TIMP-1 is not disrupted. Clinicians should consider the presence of corticosteroids, rifampicin, and LMWH when applying MMPs as biomarkers for risk stratification in patients with MS-SAB.