Skip to main content
Top
Published in: Infection 6/2018

01-12-2018 | Original Paper

Comparison of patient characteristics, clinical management, infectious specialist consultation, and outcome in men and women with methicillin-sensitive Staphylococcus aureus bacteremia: a propensity-score adjusted retrospective study

Authors: E. Forsblom, A. Kakriainen, E. Ruotsalainen, A. Järvinen

Published in: Infection | Issue 6/2018

Login to get access

Abstract

Background

Sex-related treatment inequalities are suggested to explain outcome differences between men and women in Staphylococcus aureus bacteremia (SAB). We compared patient characteristics, clinical management, infectious specialist consultation (ISC) and outcome in men and women with SAB.

Methods

Multicenter retrospective study of methicillin-sensitive (MS-) SAB patients categorized according to sex and ISC consultation provided within 7 days of diagnosis.

Results

Altogether 617 SAB patients were included in the analysis: 62% males and 38% females. Male sex was associated less often to nosocomial bacteremia (OR 0.69, 95% CI 0.50–0.96, p = 0.029) and more often to alcoholism (OR 2.25, 95% CI 1.31–3.87, p = 0.003). No sex-related differences were seen in basic or immunologic laboratory tests, illness severity, intensive care unit treatment or thromboembolic events. ISC was provided to most patients (94%) irrespective of sex. No differences were seen in clinical management of men or women: Transthoracic or -esophageal echocardiography (61% vs. 65%), deep infection (77% vs. 72%), infection removal (30% vs. 27%) and anti-staphylococcal antibiotics as first-line treatment (54% vs. 51%). However, male sex was connected to more frequent adjunctive rifampicin treatment (52% vs. 41%, p = 0.025). No difference in 28- or 90-day mortality (13% vs. 13% and 18% vs. 20%) or SAB relapse (0% vs. 1%) was observed between men and women. Propensity-score adjusted Cox proportional analysis gave no connection of sex to mortality within 90 days.

Conclusion

Patient characteristics, clinical management, ISC guidance, bacteremia relapse, and outcome did not differ in men and women with MS-SAB.
Literature
1.
go back to reference Braquet P, Alla F, Cornu C, et al. Factors associated with 12 week case-fatality in Staphylococcus aureus bacteraemia: a prospective cohort study. Clin Microbiol Infect. 2016;22:948.e1–948.e7.CrossRef Braquet P, Alla F, Cornu C, et al. Factors associated with 12 week case-fatality in Staphylococcus aureus bacteraemia: a prospective cohort study. Clin Microbiol Infect. 2016;22:948.e1–948.e7.CrossRef
2.
go back to reference Kang CI, Song JH, Ko KS, et al. Asian Network for Surveillance of Resistant Pathogens Study Group. Clinical features and outcome of Staphylococcus aureus infection in elderly versus younger adult patients. Int J Infect Dis. 2011;15:58–62.CrossRef Kang CI, Song JH, Ko KS, et al. Asian Network for Surveillance of Resistant Pathogens Study Group. Clinical features and outcome of Staphylococcus aureus infection in elderly versus younger adult patients. Int J Infect Dis. 2011;15:58–62.CrossRef
3.
go back to reference Ammerlaan H, Seifert H, Harbarth S, et al. Adequacy of antimicrobial treatment and outcome 334 of Staphylococcus aureus bacteremia in 9 Western European countries. Clin Infect Dis. 2009;49:997–1005.CrossRef Ammerlaan H, Seifert H, Harbarth S, et al. Adequacy of antimicrobial treatment and outcome 334 of Staphylococcus aureus bacteremia in 9 Western European countries. Clin Infect Dis. 2009;49:997–1005.CrossRef
4.
go back to reference Rieg S, Peyerl-Hoffmann G, de With K, et al. Mortality of S. aureus bacteremia and infectious diseases specialist consultation—a study of 521 patients in Germany. J Infect. 2009;59:232–9.CrossRef Rieg S, Peyerl-Hoffmann G, de With K, et al. Mortality of S. aureus bacteremia and infectious diseases specialist consultation—a study of 521 patients in Germany. J Infect. 2009;59:232–9.CrossRef
5.
go back to reference Cosgrove S, Sakoulas G, Perencevich E, et al. Comparison of mortality associated with methicillin resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis. 2003;36:53–9.CrossRef Cosgrove S, Sakoulas G, Perencevich E, et al. Comparison of mortality associated with methicillin resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis. 2003;36:53–9.CrossRef
6.
go back to reference Honda H, Krauss M, Jones J, et al. The value of infectious diseases consultation in Staphylococcus aureus bacteremia. Am J Med. 2010;123:631–7.CrossRef Honda H, Krauss M, Jones J, et al. The value of infectious diseases consultation in Staphylococcus aureus bacteremia. Am J Med. 2010;123:631–7.CrossRef
7.
go back to reference Saunderson R, Gouliouris T, Nickerson E, et al. Impact of routine bedside infectious disease consultation on clinical management and outcome of Staphylococcus aureus bacteraemia in adults. Clin Microbiol Infect. 2015;21:779–85.CrossRef Saunderson R, Gouliouris T, Nickerson E, et al. Impact of routine bedside infectious disease consultation on clinical management and outcome of Staphylococcus aureus bacteraemia in adults. Clin Microbiol Infect. 2015;21:779–85.CrossRef
8.
go back to reference Martin L, Harris M, Brooks A, et al. Management and outcomes in patients with Staphylococcus aureus bacteremia after implementation of mandatory infectious diseases consult: a before/after study. BMC Infect Dis. 2015;15:568.CrossRef Martin L, Harris M, Brooks A, et al. Management and outcomes in patients with Staphylococcus aureus bacteremia after implementation of mandatory infectious diseases consult: a before/after study. BMC Infect Dis. 2015;15:568.CrossRef
9.
go back to reference Adrie C, Azoulay E, Francais A, et al. Influence of gender on the outcome of severe sepsis: a reappraisal. Chest. 2007;132:1786–93.CrossRef Adrie C, Azoulay E, Francais A, et al. Influence of gender on the outcome of severe sepsis: a reappraisal. Chest. 2007;132:1786–93.CrossRef
10.
go back to reference Leibovici L, Paul M, Weinberger M, et al. Excess mortality in women with hospital-acquired bloodstream infection. Am J Med. 2001;111:120–5.CrossRef Leibovici L, Paul M, Weinberger M, et al. Excess mortality in women with hospital-acquired bloodstream infection. Am J Med. 2001;111:120–5.CrossRef
11.
go back to reference Madsen T, Simmons J, Choo E, et al. The disparity study: Do gender differences exist in surviving sepsis campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality? J Crit Care. 2014;29:473 7–11.CrossRef Madsen T, Simmons J, Choo E, et al. The disparity study: Do gender differences exist in surviving sepsis campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality? J Crit Care. 2014;29:473 7–11.CrossRef
12.
go back to reference Mejer N, Westh H, Schønheyder HC, et al. Stable incidence and continued improvement in the short term mortality of Staphylococcus aureus bacteremia between 1995–2008. BMC Infect Dis. 2012;12:260.CrossRef Mejer N, Westh H, Schønheyder HC, et al. Stable incidence and continued improvement in the short term mortality of Staphylococcus aureus bacteremia between 1995–2008. BMC Infect Dis. 2012;12:260.CrossRef
13.
go back to reference Smit J, Lopez-Cortes LE, Kaasch AJ, et al. Gender differences in the outcome of community-acquired Staphylococcus aureus bacteraemia: a historical population-based cohort study. Clin Microbiol Infect. 2017;23:27–32.CrossRef Smit J, Lopez-Cortes LE, Kaasch AJ, et al. Gender differences in the outcome of community-acquired Staphylococcus aureus bacteraemia: a historical population-based cohort study. Clin Microbiol Infect. 2017;23:27–32.CrossRef
14.
go back to reference Lamagni T, Potz N, Powell D, et al. Mortality in patients with meticillin-resistant Staphylococcus aureus bacteraemia, England 2004–2005. J Hosp Infect. 2011;77:16–20.CrossRef Lamagni T, Potz N, Powell D, et al. Mortality in patients with meticillin-resistant Staphylococcus aureus bacteraemia, England 2004–2005. J Hosp Infect. 2011;77:16–20.CrossRef
15.
go back to reference Allard C, Carignan A, Bergevin M, et al. Secular changes in incidence and mortality associated with Staphylococcus aureus bacteraemia in Quebec, Canada, 1991–2005. Clin Microbiol Infect. 2008;14:421–8.CrossRef Allard C, Carignan A, Bergevin M, et al. Secular changes in incidence and mortality associated with Staphylococcus aureus bacteraemia in Quebec, Canada, 1991–2005. Clin Microbiol Infect. 2008;14:421–8.CrossRef
16.
go back to reference Mansur N, Hazzan R, Paul M, et al. Does sex affect 30-day mortality in Staphylococcus aureus bacteremia. Gender Med. 2012;9:463–70.CrossRef Mansur N, Hazzan R, Paul M, et al. Does sex affect 30-day mortality in Staphylococcus aureus bacteremia. Gender Med. 2012;9:463–70.CrossRef
17.
go back to reference Yahav D, Yassin S, Shaked H, et al. Risk factors for long-term mortality of Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis. 2016;35:785–90.CrossRef Yahav D, Yassin S, Shaked H, et al. Risk factors for long-term mortality of Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis. 2016;35:785–90.CrossRef
18.
go back to reference Humphreys H, Fitzpatrick F, Harvey BJ. Gender differences in rates of carriage and bloodstream infection caused by methicillin-resistant Staphylococcus aureus: are they real, do they matter and why? Clin Infect Dis. 2015;61:1708–14.PubMed Humphreys H, Fitzpatrick F, Harvey BJ. Gender differences in rates of carriage and bloodstream infection caused by methicillin-resistant Staphylococcus aureus: are they real, do they matter and why? Clin Infect Dis. 2015;61:1708–14.PubMed
19.
go back to reference Angele MK, Pratschke S, Hubbard WJ, et al. Gender difference in sepsis: cardiovascular and immunological aspects. Virulence. 2014;5:12–9.CrossRef Angele MK, Pratschke S, Hubbard WJ, et al. Gender difference in sepsis: cardiovascular and immunological aspects. Virulence. 2014;5:12–9.CrossRef
20.
go back to reference Schroder W, Sommer H, Gladstone BP, et al. Gender differences in antibiotic prescribing in the community: a systematic review and meta-analysis. J Antimicrob Chemother. 2016;71:1800–6.CrossRef Schroder W, Sommer H, Gladstone BP, et al. Gender differences in antibiotic prescribing in the community: a systematic review and meta-analysis. J Antimicrob Chemother. 2016;71:1800–6.CrossRef
21.
go back to reference Madsen TE, Napoli AM. The disparity-ii study: delays to antibiotic administration in women with severe sepsis or septic shock. Acad Emerg Med. 2014;21:1499–502.CrossRef Madsen TE, Napoli AM. The disparity-ii study: delays to antibiotic administration in women with severe sepsis or septic shock. Acad Emerg Med. 2014;21:1499–502.CrossRef
22.
go back to reference Pietropaoli AP, Glance LG, Oakes D, et al. Gender differences in mortality in patients with severe sepsis or septic shock. Gender Med. 2010;7:422–37.CrossRef Pietropaoli AP, Glance LG, Oakes D, et al. Gender differences in mortality in patients with severe sepsis or septic shock. Gender Med. 2010;7:422–37.CrossRef
23.
go back to reference Raine R, Goldfrad C, Rowan K, et al. Influence of patient gender on admission to intensive care. J Epidemiol Community Health. 2002;56:418–23.CrossRef Raine R, Goldfrad C, Rowan K, et al. Influence of patient gender on admission to intensive care. J Epidemiol Community Health. 2002;56:418–23.CrossRef
24.
go back to reference Ruotsalainen E, Järvinen A, Koivula I, et al. Levofloxacin does not decrease mortality in Staphylococcus aureus bacteraemia when added to the standard treatment: a prospective and randomized clinical trial of 381 patients. J Intern Med. 2006;259:179–90.CrossRef Ruotsalainen E, Järvinen A, Koivula I, et al. Levofloxacin does not decrease mortality in Staphylococcus aureus bacteraemia when added to the standard treatment: a prospective and randomized clinical trial of 381 patients. J Intern Med. 2006;259:179–90.CrossRef
25.
go back to reference Tacconelli E, Foschi F. Does gender affect the outcome of community-acquired Staphylococcus aureus bacteraemia? Clin Microbiol Infect. 2017;23:23–5.CrossRef Tacconelli E, Foschi F. Does gender affect the outcome of community-acquired Staphylococcus aureus bacteraemia? Clin Microbiol Infect. 2017;23:23–5.CrossRef
26.
go back to reference McCabe WR, Jackson GG. Gram-negative bacteremia: I. Etiology and ecology. Arch Intern Med. 1962;110:847–55.CrossRef McCabe WR, Jackson GG. Gram-negative bacteremia: I. Etiology and ecology. Arch Intern Med. 1962;110:847–55.CrossRef
27.
go back to reference Forsblom E, Ruotsalainen E, Ollgren J, et al. Telephone consultation cannot replace bedside infectious disease consultation in the management of Staphylococcus aureus bacteraemia. Clin Infect Dis. 2012;56:527–35.CrossRef Forsblom E, Ruotsalainen E, Ollgren J, et al. Telephone consultation cannot replace bedside infectious disease consultation in the management of Staphylococcus aureus bacteraemia. Clin Infect Dis. 2012;56:527–35.CrossRef
28.
go back to reference Thwaites GE, Scarborough M, Szubert A, et al. Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2018;17:668–78.CrossRef Thwaites GE, Scarborough M, Szubert A, et al. Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2018;17:668–78.CrossRef
29.
go back to reference Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.CrossRef Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.CrossRef
Metadata
Title
Comparison of patient characteristics, clinical management, infectious specialist consultation, and outcome in men and women with methicillin-sensitive Staphylococcus aureus bacteremia: a propensity-score adjusted retrospective study
Authors
E. Forsblom
A. Kakriainen
E. Ruotsalainen
A. Järvinen
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 6/2018
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-018-1216-3

Other articles of this Issue 6/2018

Infection 6/2018 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.