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Journal of General Internal Medicine

, Volume 28, Issue 10, pp 1318–1325 | Cite as

Gender Differences in Risk of Bloodstream and Surgical Site Infections

  • Bevin CohenEmail author
  • Yoon Jeong Choi
  • Sandra Hyman
  • E. Yoko Furuya
  • Matthew Neidell
  • Elaine Larson
Original Research

Abstract

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.

KEY WORDS

surgical site infection bloodstream infection healthcare-associated infection gender 

Notes

Acknowledgments

Contributors

We gratefully acknowledge Mandar Apte, Christie Jeon, and Matthew Sinisi for their assistance with data management and analysis.

Funders

This work was funded by a grant from the National Institute of Nursing Research, National Institutes of Health (R01 NR010822).

Prior Presentations

This work was presented at the Association for Professionals in Infection Control and Epidemiology 39th Annual Educational Conference and International Meeting in June, 2012.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2013_2421_MOESM1_ESM.docx (26 kb)
ESM 1 (DOCX 26 kb)

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Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Bevin Cohen
    • 1
    Email author
  • Yoon Jeong Choi
    • 1
  • Sandra Hyman
    • 2
  • E. Yoko Furuya
    • 3
  • Matthew Neidell
    • 4
  • Elaine Larson
    • 1
  1. 1.Columbia University School of NursingNew YorkUSA
  2. 2.Perioperative Services, NewYork-Presbyterian Hospital,Columbia University Medical CenterNew YorkUSA
  3. 3.Division of Infectious Diseases, College of Physicians and Surgeons,Columbia UniversityNew YorkUSA
  4. 4.Department of Health Policy and Management, Mailman School of Public Health,Columbia UniversityNew YorkUSA

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