Sex and Gender Differences in Bacterial Infections

Dias, Sara P.; Brouwer, Matthijs C.; Beek, Diederik van de

doi:10.1128/iai.00283-22

Cited by 54 publications

(54 citation statements)

References 237 publications

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“…The higher occurrence of E. coli in female patients may be related to not only a shorter urethra but also sex hormones. (Dias, et al 2022) Generally, males are susceptible to infection with Gram-positive bacteria, while females tend to be infected by Gram-negative bacteria. (De Lorenzis, et al 2020) Specifically, the incidence of P. aeruginosa in males was higher than that in females.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2023

Pak. J. Pharm. Sci.,

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To investigate the distribution characteristics and antibiotic resistance patterns of uropathogens in patients with upper urinary calculi and urinary tract infections, data on sex, age, positive midstream urine culture results and drug sensitivity results were collected. The statistical program SPSS 26.0 was used for statistical analysis. Among the 1414 positive urine samples, the most common pathogens were Escherichia coli (36.4%), Enterococcus faecalis (13.8%), Staphylococcus epidermidis (7.5%), Klebsiella pneumoniae (5.0%), Streptococcus agalactiae (3.4%) and Enterococcus faecium (3.3%). The incidences of E. coli (48.6%), K. pneumoniae (6.3%) and Proteus mirabilis (4.2%) were higher in female patients than in male patients (23.2%, 3.5%, 0.6%, respectively; P<0.05). E. faecalis was detected more frequently in the young group (16.0%) than in the elderly group (11.2%; P<0.01). Most of the isolates were resistant to levofloxacin and ciprofloxacin, while few were resistant to imipenem, meropenem, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin. The bacterial spectra in patients with urinary stones varied by sex and age, which should be taken into consideration during treatment. The proportion of E. faecium showed an upward trend, while those of S. epidermidis and S. agalactiae demonstrated downward trends in the study period. Regardless, carbapenems, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin are good choices for serious cases.

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Section: Discussionmentioning

confidence: 99%

Untitled

2023

Pak. J. Pharm. Sci.,

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“…Saeed and others in the Kingdom of Bahrain [ 41 ] documented a similar finding. Women have a stronger immunity to bacterial infections [ 48 ]. Coupled with differences in lifestyles such as higher smoking and drinking, adherence to treatment, and attitudes toward the Covid-19 preventive measures, including frequent handwashing [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Women have a stronger immunity to bacterial infections [ 48 ]. Coupled with differences in lifestyles such as higher smoking and drinking, adherence to treatment, and attitudes toward the Covid-19 preventive measures, including frequent handwashing [ 48 , 49 ]. Females' stronger immunity to infections may explain the observed gender-based distribution of BIs in our study.…”

Section: Discussionmentioning

confidence: 99%

Multidrug resistant bacterial infections in severely ill COVID-19 patients admitted in a national referral and teaching hospital, Kenya

2022

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Background Bacterial infections are a common complication in patients with seasonal viral respiratory tract infections and are associated with poor prognosis, increased risk of intensive care unit admission and 29–55% mortality. Yet, there is limited data on the burden of bacterial infections among COVID-19 patients in Africa, where underdeveloped healthcare systems are likely to play a pertinent role in the epidemiology of the COVID-19 pandemic. Here, we evaluated the etiologies, antimicrobial resistance profiles, risk factors, and outcomes of bacterial infections in severely ill COVID-19 patients. Methods A descriptive cross-sectional study design was adopted in severely ill COVID-19 patients at Kenyatta National Hospital, Kenya, from October to December 2021. We used a structured questionnaire and case report forms to collect sociodemographics, clinical presentation, and hospitalization outcome data. Blood, nasal/oropharyngeal swabs and tracheal aspirate samples were collected based on the patient's clinical presentation and transported to the Kenyatta National Hospital microbiology laboratory for immediate processing following the standard bacteriological procedures. Results We found at least one bacterial infection in 44.2% (53/120) of the patients sampled, with a 31.7% mortality rate. Pathogens were mainly from the upper respiratory tract (62.7%, 42/67), with gram-negative bacteria dominating (73.1%, 49/67). Males were about three times more likely to acquire bacterial infection (p = 0.015). Those aged 25 to 44 years (p = 0.009), immunized against SARS-CoV-2 (p = 0.027), and admitted to the infectious disease unit ward (p = 0.031) for a short length of stay (0–5 days, p < 0.001) were more likely to have a positive outcome. Multidrug-resistant isolates were the majority (64.3%, 46/67), mainly gram-negative bacteria (69.6%, 32/46). The predominant multidrug-resistant phenotypes were in Enterococcus cloacae (42.9%, 3/7), Klebsiella pneumonia (25%, 4/16), and Escherichia coli (40%, 2/5). Conclusion Our findings highlight a high prevalence of multidrug-resistant bacterial infections in severely ill COVID-19 patients, with male gender as a risk factor for bacterial infection. Elderly Patients, non-SARS-CoV-2 vaccination, intensive care unit admission, and long length of hospital stay were associated with poor outcomes. There is a need to emphasize strict adherence to infection and prevention at KNH-IDU and antimicrobial stewardship in line with local and global AMR control action plans.

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“…Gender differences in accessing healthcare are well recognized (Dias et al, 2022;Govender & Penn-Kekana, 2008). For Lyme borreliosis, females typically represent a higher proportion of localized infections and erythema migrans, whereas males comprise a higher proportion of disseminated disease cases (Eliassen et al, 2017;Nygård et al, 2005;Skufca et al, 2022;Tulloch et al, 2019Tulloch et al, , 2020.…”

Section: Re Sultsmentioning

confidence: 99%

Demographic patterns in Lyme borreliosis seasonality over 25 years

Goren

Mysterud

Jore

et al. 2023

Zoonoses and Public Health

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Lyme borreliosis, the most common vector‐borne disease in Europe and North America, is attracting growing concern due to its expanding geographic range. The growth in incidence and geographic spread is largely attributed to climate and land‐use changes that support the tick vector and thereby increase disease risk. Despite a wide range of symptoms displayed by Lyme borreliosis patients, the demographic patterns in clinical manifestations and seasonal case timing have not been thoroughly investigated and may result from differences in exposure, immunity and pathogenesis. We analysed 25 years of surveillance data from Norway, supplemented by population demography data, using a Bayesian modelling framework. The analyses aimed to detect differences in case seasonality and clinical manifestations of Lyme borreliosis across age and sex differentiated patient groups. The results showed a bimodal pattern of incidence over age, where children (0–9 years) had the highest incidence, young adults (20–29 years) had low incidence and older adults had a second incidence peak in the ages 70–79 years. Youth (0–19 years) presented with a higher proportion of neuroborreliosis cases and a lower proportion of arthritic manifestations compared to adults (20+ years). Adult males had a higher overall incidence than adult females and a higher proportion of arthritis cases. The seasonal timing of Lyme borreliosis consistently occurred around 4.4 weeks earlier in youth compared to adults, regardless of clinical manifestation. All demographic groups exhibited a shift towards an earlier seasonal timing over the 25‐year study period, which appeared unrelated to changes in population demographics. However, the disproportionate incidence of Lyme borreliosis in seniors requires increased public awareness and knowledge about this high‐risk group as the population continues to age concurrently with disease emergence. Our findings highlight the importance of considering patient demographics when analysing the emergence and seasonal patterns of vector‐borne diseases using long‐term surveillance data.

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Sex and Gender Differences in Bacterial Infections

Abstract: There is a growing awareness of the importance of sex and gender in medicine and research. Women typically have stronger immune responses to self and foreign antigens than men, resulting in sex-based differences in autoimmunity and infectious diseases.

Cited by 54 publications

References 237 publications

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Multidrug resistant bacterial infections in severely ill COVID-19 patients admitted in a national referral and teaching hospital, Kenya

Demographic patterns in Lyme borreliosis seasonality over 25 years

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