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Bugs That Can Resist Antibiotics but Not Men: Gender-Specific Differences in Notified Infections and Colonisations in
Michael Brandl1,2, Alexandra Hoffmann3, Niklas Willrich3
1Postgraduate Training for Applied Epidemiology, Department of Infectious Disease Epidemiology, Robert Koch Institute, 10113 Berlin, Germany.
Abstract:
Data from surveillance networks show that men have a higher incidence rate of infections with anti-microbial-resistant (AMR) pathogens than women. We systematically analysed data of infections and colonisations with AMR pathogens under mandatory surveillance in Germany to quantify gender-specific differences. We calculated incidence-rates (IR) per 100,000 person-years for invasive infections with Methicillin-resistant Staphylococcus aureus (MRSA), and for infections or colonisations with carbapenem-non-susceptible Acinetobacter spp. (CRA), and Enterobacterales (CRE), using the entire German population as a denominator. We limited the study periods to years with complete notification data (MRSA: 2010-2019, CRA/CRE: 2017-2019). We used Poisson regression to adjust for gender, age group, federal state, and year of notification. In the study periods, IR for all notifications were 4.2 for MRSA, 0.90 for CRA, and 4.8 for CRE per 100,000 person--years. The adjusted IR ratio for infections of men compared to women was 2.3 (95% confidence interval [CI]: 2.2-2.3) for MRSA, 2.2 (95%CI: 1.9-2.7) for CRA, and 1.7 (95%CI: 1.6-1.8) for CRE. Men in Germany show about double the risk for infection with AMR pathogens than women. This was also true for colonisations, where data were available. Screening procedures and associated hygiene measures may profit from a gender-stratified approach.
Insights
Men in Germany face approximately double the risk of infections and colonizations from antimicrobial-resistant (AMR) pathogens compared to women. This finding highlights the need for gender-stratified approaches in surveillance and hygiene strategies to combat AMR.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Surveillance data indicate higher infection rates of antimicrobial-resistant (AMR) pathogens in men than women.
- Quantifying these gender-specific differences is crucial for targeted public health interventions.
Purpose of the Study:
- To systematically analyze mandatory surveillance data in Germany to quantify gender-specific differences in AMR pathogen infections and colonizations.
- To compare incidence rates (IR) of Methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-non-susceptible Acinetobacter spp. (CRA), and carbapenem-non-susceptible Enterobacterales (CRE) between men and women.
Main Methods:
- Analysis of mandatory surveillance data in Germany from 2010-2019 (MRSA) and 2017-2019 (CRA/CRE).
- Calculation of incidence rates per 100,000 person-years using the entire German population as the denominator.
- Poisson regression was used to adjust for age group, federal state, and year of notification.
Main Results:
- Adjusted incidence rate ratios (IRR) for men compared to women were 2.3 for MRSA, 2.2 for CRA, and 1.7 for CRE.
- Men exhibited approximately double the risk of infection with these AMR pathogens.
- Similar trends were observed for colonizations where data were available.
Conclusions:
- Men in Germany have a significantly higher risk of infection and colonization with key AMR pathogens compared to women.
- Gender-stratified screening procedures and hygiene measures could enhance the effectiveness of AMR control strategies.
- Further research into the underlying reasons for gender disparities in AMR is warranted.
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