Gender affects prognosis of methicillin-resistant Staphylococcus aureus bacteremia differently depending on the severity of underlying disease

Eur J Clin Microbiol Infect Dis. 2018 Jun;37(6):1119-1123. doi: 10.1007/s10096-018-3226-6. Epub 2018 Apr 17.

Abstract

We aimed to elucidate the potential impact of gender on prognosis of Staphylococcus aureus bacteremia (SAB). We analyzed SAB cases prospectively collected over an 8-year period at 11 hospitals in Korea. SAB-related mortality was pre-defined as a death within 30 days from the onset of SAB without other apparent cause of death. The effect of gender on SAB-related mortality was examined in the entire cohort and in subgroups stratified according to methicillin resistance and Charlson's comorbidity-weighted index (CCWI) score. Those factors independently associated to SAB-related mortality were explored. Among 1974 eligible cases, SAB-related mortality rates in male and female were 21.2% (259/1224) and 21.9% (164/750), respectively (P = 0.786). The SAB-related mortality rate was independently higher in male than that in female in CCWI score ≤ 3 methicillin-resistant SAB (MRSAB) group (15.9 vs. 6.2%; aOR 3.65, 95% CI 1.46-9.13; P = 0.006) while the association tended to be inverse when CCWI score rises. Interaction between CCWI score and gender to MRSAB-related mortality was significant in multivariate analysis (aOR 0.85, 95% CI 0.74-0.96; P = 0.011). There was no significant interaction between gender and CCWI in entire SAB or methicillin-susceptible SAB cohorts. Gender may affect clinical outcomes of MRSAB differently depending on the severity of underlying disease.

Keywords: Bacteremia; Gender; MRSA; Mortality; Underlying disease.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Bacteremia / diagnosis*
  • Bacteremia / epidemiology
  • Bacteremia / microbiology
  • Bacteremia / mortality*
  • Cohort Studies
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Female
  • Hospitals
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Prognosis
  • Republic of Korea
  • Severity of Illness Index
  • Sex Factors
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / mortality

Substances

  • Anti-Bacterial Agents