455. Gender Differences in Clinical, Microbiological and Treatment Characteristics of Adult Hospitalized Patients with Cellulitis: A Large, Prospective Multicenter Study
Author(s) -
Julio Collazos,
Belén de la Fuente,
Javier de la Fuente,
Alicia García,
Helena Gómez,
María Rivas-Carmenado,
Tomás SuárezZarracina,
Héctor Enríquez,
Paula Sánchez,
María Alonso,
Ian LópezCruz,
Manuel Martín-Regidor,
Ana Martínez-Alonso,
José Guerra,
Arturo Artero,
Marino Blanes,
Víctor Asensi
Publication year - 2019
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofz360.528
Subject(s) - medicine , cellulitis , prospective cohort study , blood culture , logistic regression , observational study , antibiotics , cellulite , surgery , microbiology and biotechnology , biology
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.
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