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Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis.

Publication ,  Journal Article
Westgeest, AC; Lambregts, MMC; Ruffin, F; Korn, RE; Webster, ME; Kair, JL; Parsons, JB; Maskarinec, SA; Kaplan, S; Dekkers, OM; de Boer, MGJ ...
Published in: JAMA Netw Open
February 5, 2024

IMPORTANCE: Staphylococcus aureus is the leading cause of death due to bacterial bloodstream infection. Female sex has been identified as a risk factor for mortality in S aureus bacteremia (SAB) in some studies, but not in others. OBJECTIVE: To determine whether female sex is associated with increased mortality risk in SAB. DATA SOURCES: MEDLINE, Embase, and Web of Science were searched from inception to April 26, 2023. STUDY SELECTION: Included studies met the following criteria: (1) randomized or observational studies evaluating adults with SAB, (2) included 200 or more patients, (3) reported mortality at or before 90 days following SAB, and (4) reported mortality stratified by sex. Studies on specific subpopulations (eg, dialysis, intensive care units, cancer patients) and studies that included patients with bacteremia by various microorganisms that did not report SAB-specific data were excluded. DATA EXTRACTION AND SYNTHESIS: Data extraction and quality assessment were performed by 1 reviewer and verified by a second reviewer. Risk of bias and quality were assessed with the Newcastle-Ottawa Quality Assessment Scale. Mortality data were combined as odds ratios (ORs). MAIN OUTCOME AND MEASURES: Mortality at or before 90-day following SAB, stratified by sex. RESULTS: From 5339 studies retrieved, 89 were included (132 582 patients; 50 258 female [37.9%], 82 324 male [62.1%]). Unadjusted mortality data were available from 81 studies (109 828 patients) and showed increased mortality in female patients compared with male patients (pooled OR, 1.12; 95% CI, 1.06-1.18). Adjusted mortality data accounting for additional patient characteristics and treatment variables were available from 32 studies (95 469 patients) and revealed a similarly increased mortality risk in female relative to male patients (pooled adjusted OR, 1.18; 95% CI, 1.11-1.27). No evidence of publication bias was encountered. CONCLUSIONS AND RELEVANCE: In this systematic review and meta-analysis, female patients with SAB had higher mortality risk than males in both unadjusted and adjusted analyses. Further research is needed to study the potential underlying mechanisms.

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Published In

JAMA Netw Open

DOI

EISSN

2574-3805

Publication Date

February 5, 2024

Volume

7

Issue

2

Start / End Page

e240473

Location

United States

Related Subject Headings

  • Staphylococcus aureus
  • Staphylococcal Infections
  • Sepsis
  • Renal Dialysis
  • Male
  • Humans
  • Female
  • Bacteremia
  • Adult
  • 42 Health sciences
 

Citation

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Westgeest, A. C., Lambregts, M. M. C., Ruffin, F., Korn, R. E., Webster, M. E., Kair, J. L., … Thaden, J. T. (2024). Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis. JAMA Netw Open, 7(2), e240473. https://doi.org/10.1001/jamanetworkopen.2024.0473
Westgeest, Annette C., Merel M. C. Lambregts, Felicia Ruffin, Rachel E. Korn, Maren E. Webster, Jackson L. Kair, Joshua B. Parsons, et al. “Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis.JAMA Netw Open 7, no. 2 (February 5, 2024): e240473. https://doi.org/10.1001/jamanetworkopen.2024.0473.
Westgeest AC, Lambregts MMC, Ruffin F, Korn RE, Webster ME, Kair JL, et al. Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis. JAMA Netw Open. 2024 Feb 5;7(2):e240473.
Westgeest, Annette C., et al. “Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis.JAMA Netw Open, vol. 7, no. 2, Feb. 2024, p. e240473. Pubmed, doi:10.1001/jamanetworkopen.2024.0473.
Westgeest AC, Lambregts MMC, Ruffin F, Korn RE, Webster ME, Kair JL, Parsons JB, Maskarinec SA, Kaplan S, Dekkers OM, de Boer MGJ, Fowler VG, Thaden JT. Female Sex and Mortality in Patients with Staphylococcus aureus Bacteremia: A Systematic Review and Meta-analysis. JAMA Netw Open. 2024 Feb 5;7(2):e240473.

Published In

JAMA Netw Open

DOI

EISSN

2574-3805

Publication Date

February 5, 2024

Volume

7

Issue

2

Start / End Page

e240473

Location

United States

Related Subject Headings

  • Staphylococcus aureus
  • Staphylococcal Infections
  • Sepsis
  • Renal Dialysis
  • Male
  • Humans
  • Female
  • Bacteremia
  • Adult
  • 42 Health sciences