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455. Gender Differences in Clinical, Microbiological and Treatment Characteristics of Adult Hospitalized Patients with Cellulitis: A Large, Prospective Multicenter Study

BACKGROUND: Studies comparing gender differences between cellulitis features are lacking and might be useful for the knowledge, prevention and management of this infection. METHODS: Prospective, observational, multicenter study of 606 adult patients (314, 51.8% men) with cellulitis. Comorbidities, m...

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Detalles Bibliográficos
Autores principales: Collazos, Julio, De la Fuente, Belén, De la Fuente, Javier, Garcia, Alicia, Gomez, Helena, Rivas-Carmenado, Maria, Suárez-Zarracina, Tomás, Enriquez, Hector, Sánchez, Paula, Alonso, María, López-Cruz, Ian, Martin-Regidor, Manuel, Martinez-Alonso, Ana, Guerra, José, Artero, Arturo, Blanes, Marino, Asensi, Victor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809705/
http://dx.doi.org/10.1093/ofid/ofz360.528
Descripción
Sumario:BACKGROUND: Studies comparing gender differences between cellulitis features are lacking and might be useful for the knowledge, prevention and management of this infection. METHODS: Prospective, observational, multicenter study of 606 adult patients (314, 51.8% men) with cellulitis. Comorbidities, microbiological, clinical, lab, diagnostic, and treatment data were analyzed. Multiple logistic regression modeling was performed to determine the variables independently associated with gender. RESULTS: Women were older (P < 0.0001), less likely to have prior wounds (P = 0.02), and more likely to have venous insufficiency (P = 0.0002), edema/ lymphedema (P < 0.0003) and prior cellulitis episodes than men (P = 0.07). Cellulitis location also differed between genders (P = 0.02). Regarding microbiology, male patients were more likely to have positive pus cultures than women (P = 0.0008), mainly monomicrobial (P = 0.03).There were differences in microorganisms isolated from pus (P = 0.002), with higher S.aureus infection rates among men than women (P = 0.04).Drawing of blood for culture was also more common in men (P = 0.03). Overall, any microorganism (P = 0.006) and the causative microorganism (P = 0.04) were more commonly identified in male than in female patients, due exclusively to the pus culture results, because there were no differences in the positivity of blood cultures (P = 0.9).Of the 61 S.aureus isolates 15 (24.6%) were methicillin-resistant, without significant differences between genders (P = 0.5). Regarding therapy, men had longer treatments (P = 0.03) and higher rates of antibiotic treatment after discharge (P = 0.04). Factors independently associated with female gender in multivariate analysis were:older age (P < 0.0001), prior episodes of cellulitis (P = 0.01), presence of edema/lymphedema as predisposing factor (P = 0.004), negative pus culture (P = 0.0002) and location of cellulitis in thorax/abdomen (P = 0.035) and head/neck (P = 0.0003) as compared with lower extremities CONCLUSION: Cellulitis in women as compared with men present at older ages, recur more frequently, are more commonly related to edema/lymphedema, affect more frequently other locations compared with lower extremities, and have less frequently positive pus cultures. DISCLOSURES: All authors: No reported disclosures.