194 Chapter 9 Definitions Sex was defined as biological sex assigned at birth [12]. The following sources were considered primary endovascular infection: central venous catheters, arterio-venous fistulas, subcutaneous catheters, intracardiac devices and endovascular grafts [13]. The route of acquisition was classified as hospital-acquired, healthcare-associated or community-acquired as previously defined [14]. The duration of symptoms was defined as the time from the patient-reported onset of symptoms to the day of first positive blood culture. Recurrent SAB after this first episode was defined as a second episode of SAB after resolution of this first and occurring at least 14 days after the last positive blood culture associated with this episode [15]. Persistent bacteraemia was defined as ≥ 3 days of positive blood cultures after appropriate treatment was initiated [2]. Patients were considered to have a hematogenous metastatic infection if they exhibited any of the following conditions during their hospitalization for SAB: infective endocarditis, vertebral osteomyelitis, septic arthritis, septic emboli, septic thrombophlebitis or deep tissue abscess [2]. Main antibiotic regimen was defined as the primary antibiotic used for definitive treatment of the episode of SAB. Bacterial genotyping The S. aureus isolates from the first blood culture obtained from enrolled patients underwent spa genotyping and further analyses to determine USA300 clone as previously described [2,16]. Outcome measures and statistical analysis The primary study outcome was 90-day mortality, stratified by sex. The time count started from the day of the first positive blood culture. Secondary outcomes were 30-day mortality, and differences in patient, disease and management characteristics between women and men. Data were presented as counts plus percentages or proportions for categorical variables and as medians plus interquartile ranges (IQR) for continuous variables. Fisher’s exact, Chi-square and Mann-Whitney U tests were used to analyse differences in patient and disease characteristics. Survival curves were constructed using the Kaplan-Meier method. Cox regression analysis was used to assess the independent effect of female sex on mortality. Variables with p < 0.01 in univariable analysis and clinically relevant variables were added to the multivariable analysis. To evaluate differences in subgroups, mortality by sex was additionally analysed for methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) separately, stratified for route of acquisition and for different time periods. All statistical analyses were performed using IBM SPSS statistics version 28.0.1.1.
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