SAB Proven More Fatal in Women Than Men

Staphylococcus aureus is a major cause of bacteraemia, and compared with other pathogens, S. aureus bacteremia holds a higher risk of morbidity and mortality. Doctors worldwide have suspected that S. aureus bacteraemia found in women would lead to a worse outcome than the same bacteraemia found in men, but evidence to establish this gender difference had not yet been established, until now. A study published in the journal of Clinical Microbiology and Infection confirms that significantly more women than men who are diagnosed with Staphylococcus aureus bacteraemia (SAB) will die within 30 days.

According to an article by the Centers for Disease Control and Prevention (CDC), SAB is common and continues to be an increasing problem worldwide. Death rates remain high, even with the aid of antimicrobial drug treatment, mainly due to a consistent increase in antimicrobial drug resistance in S. aureus. Despite the fact that S. aureus remains a common cause of bloodstream infections, many of these infections are healthcare associated, and according to the CDC, that means that they are “potentially preventable.”

Researchers from Spain and Denmark used population-based medical registers in northern Denmark from 2000 to 2011 to conduct their study of adult patients with SAB. Using the Kaplan-Meier method, the researchers analyzed data on 2,638 SAB-diagnosed patients, and estimated the thirty-day mortality for both male and female patients with SAB.

The study found that within the first 30 days, 29% of the women had died compared to 22% of the men, making women 1.3 times more likely to die within a month of contracting SAB.

Jesper Smit, PhD, Aaalborg University Hospital, one of the study’s authors, noted in a news release by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), that the gender and fatality link could be witnessed across all age groups and the impact of gender was most pronounced in women who were diabetic or who were diagnosed with chronic pulmonary disease or cancer. However, researchers did not find a link between gender and infective endocarditis, infection of the inner lining of the heart, and osteomyelitis, infection of the bone, two common complications of SAB.

When speaking on further implications of the study, Smit said, “Although we now know that women in this situation are at a higher risk of death compared to men, we do not yet understand why. Further studies are needed to uncover the cellular and molecular mechanisms but the information we have generated should aid clinical decision making by helping to define which patients are most vulnerable.”

Based on their findings, the researchers of the study recommend that gender should be considered as a key element in the triage and risk stratification of SAB patients.