Does sex affect 30-day mortality in Staphylococcus aureus bacteremia?

Sex-related differences in complications and mortality of infection were examined with conflicting results. Further studies are required to bring new light in this topic in Staphylococcus aureus infections.

We examined the outcomes of S. aureus infection in men and in women and whether sex-related differences were explained by underlying disorders, severity of disease, or clinical management.

This cohort study was conducted in a single center between 1988 and 2007. Patients with clinically significant S. aureus bacteremia were included. We compared 30-day all-cause mortality in men and women. We used multivariable logistic regression analysis to test whether sex was independently associated with mortality.

One thousand ninety-three patients were identified with S. aureus bacteremia. All-cause mortality at day 30 was 39.3% (508 of 1293 patients): 44.8% (238 of 531 patients) in women and 35.4% (270 of 762 patients) in men (P < 0.01). In a multivariate analysis, female sex was associated with higher mortality (odds ratio = 1.63; 95% CI, 1.07-2.47). The excess mortality in women was not explained by differences in demographic characteristic factors, background conditions, infection severity and management, or septic complications.

We found that women with S. aureus bacteremia had a greater risk of 30-day all-cause mortality than men, even when adjusting for other risk factors. However, we failed to explain this excess of mortality.