Brandl Michael, Hoffmann Alexandra, Willrich Niklas, Reuss Annicka, Reichert Felix, Walter Jan, Eckmanns Tim, Haller Sebastian
Postgraduate Training for Applied Epidemiology, Department of Infectious Disease Epidemiology, Robert Koch Institute, 10113 Berlin, Germany.
European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), 17183 Stockholm, Sweden.
Microorganisms. 2021 Apr 22;9(5):894. doi: 10.3390/microorganisms9050894.
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 (MRSA), and for infections or colonisations with carbapenem-non-susceptible 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.
监测网络数据显示，男性感染抗菌药物耐药（AMR）病原体的发病率高于女性。我们系统分析了德国强制性监测下AMR病原体感染和定植的数据，以量化性别差异。我们以德国全体人口为分母，计算了耐甲氧西林金黄色葡萄球菌（MRSA）侵袭性感染、碳青霉烯不敏感菌（CRA）以及肠杆菌科（CRE）感染或定植每10万人年的发病率（IR）。我们将研究期限定为有完整报告数据的年份（MRSA：2010 - 2019年，CRA/CRE：2017 - 2019年）。我们使用泊松回归来调整性别、年龄组、联邦州和报告年份的影响。在研究期内，每10万人年所有报告的IR，MRSA为4.2，CRA为0.90，CRE为4.8。男性与女性感染的调整后IR比值，MRSA为2.3（95%置信区间[CI]：2.2 - 2.3），CRA为2.2（95%CI：1.9 - 2.7），CRE为1.7（95%CI：1.6 - 1.8）。德国男性感染AMR病原体的风险约为女性的两倍。在有数据的定植情况中也是如此。筛查程序和相关卫生措施可能会从性别分层方法中受益。
