Gender Differences in Risk of Bloodstream and Surgical Site Infections

• Published in: Journal of general internal medicine : JGIM Vol. 28; no. 10; pp. 1318 - 1325
• Main Authors: Cohen, Bevin, Choi, Yoon Jeong, Hyman, Sandra, Furuya, E. Yoko, Neidell, Matthew, Larson, Elaine
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.10.2013; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Distribution; Aged; Bacteremia - epidemiology; Bacteremia - etiology; Bacterial infections; Blood; Child; Cross Infection - epidemiology; Cross Infection - etiology; Female; Gender differences; Hospitalization; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; New York - epidemiology; Original Research; Retrospective Studies; Risk Factors; Sex Characteristics; Surgery; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Young Adult; New York; bloodstream infection; healthcare-associated infection; gender; surgical site infection
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-013-2421-5

BACKGROUND Identifying patients most at risk for hospital- and community-associated infections is one essential strategy for preventing infections. OBJECTIVE To investigate whether rates of community- and healthcare-associated bloodstream and surgical site infections varied by patient gender in a large cohort after controlling for a wide variety of possible confounders. DESIGN Retrospective cohort study. PARTICIPANTS All patients discharged from January 1, 2006 through December 31, 2008 (133,756 adult discharges and 66,592 pediatric discharges) from a 650-bed tertiary care hospital, a 220-bed community hospital, and a 280-bed pediatric acute care hospital within a large, academic medical center in New York, NY. MAIN MEASURES Data were collected retrospectively from various electronic sources shared by the hospitals and linked using patients’ unique medical record numbers. Infections were identified using previously validated computerized algorithms. KEY RESULTS Odds of community-associated bloodstream infections, healthcare-associated bloodstream infections, and surgical site infections were significantly lower for women than for men after controlling for present-on-admission patient characteristics and events during the hospital stay [odds ratios (95 % confidence intervals) were 0.85 (0.77–0.93), 0.82 (0.74–0.91), and 0.78 (0.68–0.91), respectively]. Gender differences were greatest for older adolescents (12–17 years) and adults 18–49 years and least for young children (<12 years) and older adults (≥70 years). CONCLUSIONS In this cohort, men were at higher risk for bloodstream and surgical site infections, possibly due to differences in propensity for skin colonization or other anatomical differences.