Gender affects prognosis of methicillin-resistant Staphylococcus aureus bacteremia differently depending on the severity of underlying disease
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.
KeywordsGender Underlying disease MRSA Bacteremia Mortality
The study involved three multicenter SAB cohorts. The cohorts comprised SAB cases occurring from July 2009 to June 2011 (grants 02-2012-035 from the SNUBH Research Fund and 2009-E00609-00 from the Korea Centers for Disease Control and Prevention) , from May to December 2012 (grant 2012-E44003-00 from the Korea Centers for Disease Control and Prevention) , and from September 2013 to March 2015 (grant HI10C2020 from the National Strategic Coordinating Centre for Clinical Research, for the cohort study “Korea Infectious Diseases Study Group/Staphylococcus aureus Bacteremia 2013[KIND-SAB 2013]”) [8, 9].
We thank the members of the Korea INfectious Diseases (KIND) study group and associated staff for their cooperation in this study. In addition to the authors, the following were participants in the study group: Taek Soo Kim, Kyoung Un Park, Jeong Eun Cho, Yun Jung Choi, Jung In Park (Seoul National University Bundang Hospital); Chong Rae Cho, Hyun Suk Song, Young Soon Lee (Inje University Ilsan Paik Hospital); Su-Mi Choi (Chonnam National University Hospital); Myoung-don Oh, Pyoeng Gyun Choe, Su Jin Choi (Seoul National University Hospital); Hee Kyoung Choi, Myung Sook Han (Yonsei University Wonju Severance Christian Hospital); Seung-Ji Kang, Hyeon-jeong Hwang (Chonnam National University Hwasun Hospital); Shinhye Cheon, Jin Hee Hwang, Seon Jin Yun (Chungnam National University Hospital); Jongyoun Yi, Sohee Park (Pusan National University Hospital); Sungmin Kiem, Dong-Kie Kim, Sae-Am Song, Min Ji Kang, and Jae Gyun Shin (Inje University Haeundae Paik Hospital); Hye-In Kim, Seung Min Shin (Daegu Fatima Hospital).
This work was supported by SNUBH Research Fund (Grant No. 02-2017-003) and Support Program for Women in Science, Engineering and Technology through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (Grant No. 2016H1C3A1903202).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Formal consent was not required in this study. The analyses of cases from April 2015 to February 2017 were also approved by the institutional review board of Seoul National University Bundang Hospital (IRB No. B-1708-417-106).
No identifying information is included.
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