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

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

Author information

1
Seoul National University Bundang Hospital, Seongnam, South Korea.
2
Inje University Ilsan Paik Hospital, Goyang, South Korea.
3
Chonnam National University Hospital, Gwangju, South Korea.
4
Seoul National University Hospital, Seoul, South Korea.
5
Yonsei University Wonju College of Medicine, Wonju, South Korea.
6
Chonnam National University Hwasun Hospital, Hwasun, South Korea.
7
Pusan National University Hospital, Busan, South Korea.
8
Inje University Haeundae Paik Hospital, Busan, South Korea.
9
Daegu Fatima Hospital, Daegu, South Korea.
10
Ehwa Womans University Hospital, Seoul, South Korea.
11
Chungnam National University School of Medicine, Daejeon, Republic of Korea. alice@cnuh.co.kr.
12
Seoul National University Bundang Hospital, Seongnam, South Korea. hbkimmd@snu.ac.kr.

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

PMID:
29667110
DOI:
10.1007/s10096-018-3226-6
[Indexed for MEDLINE]

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