Kodde C, Bonsignore M, Köhler J, Schwegmann K, Nachtigall I
Department of Infectious Diseases and Respiratory Medicine, Charité-Universitaetsmedizin Berlin, Berlin, Germany; Department of Respiratory Diseases 'Heckeshorn', Helios Hospital Emil-von-Behring, Berlin, Germany.
Department of Infectious Diseases and Prevention, Helios Hospitals Duisburg, Duisburg, Germany; Centre for Clinical and Translational Research, Helios Universitätsklinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.
J Hosp Infect. 2025 Jan;155:88-94. doi: 10.1016/j.jhin.2024.07.021. Epub 2024 Oct 11.
The global rise in multi-drug-resistant organisms (MDROs) is alarming, and antimicrobial resistance poses a significant public health threat globally. Although certain risk factors are known, including recent antimicrobial therapy, inappropriate use and hospitalization, the focus on gender-specific aspects in MDROs is scarce. The aim of this study was to show gender-specific differences in colonization and infection of multiple MDROs and their detection sites.
For this multi-centre, retrospective cohort study, surveillance data were collected between 2015 and 2020 from 86 hospitals from Helios Kliniken, Germany. The following multi-drug-resistant bacteria were analysed by sample site: meticillin-resistant Staphylococcus aureus (MRSA); Enterococcus spp.; Escherichia coli; Klebsiella pneumoniae; Pseudomonas aeruginosa; and Acinetobacter baumannii.
Of the 7,081,708 cases in the database, 187,656 patients were found to be colonized with MDROs (2.65%). A documented infection with an MDRO was identified in 33,023 patients (0.466%), with the origin of infection known in 24,231 cases. Male gender was a risk factor for both infection and colonization with any MDRO (P<0.001). Males exhibited a higher likelihood of MDRO detection in superficial skin/soft tissue, blood cultures (P<0.001) and respiratory samples (P=0.002). Additionally, gender-specific differences in MDRO detection site and pathogens were found, with a slightly higher proportion of MRSA infections in deep skin/soft tissue and respiratory samples for females.
This study reinforces the existing hypothesis that male gender is a risk factor for colonization and infection with MDROs, supported by a large dataset. This highlights the need to acknowledge gender-specific MDRO susceptibility in clinical practice.
全球多重耐药菌（MDROs）的增加令人担忧，抗菌药物耐药性在全球范围内构成了重大的公共卫生威胁。尽管已知某些风险因素，包括近期的抗菌治疗、不当使用和住院治疗，但对MDROs中性别特异性方面的关注却很少。本研究的目的是揭示多种MDROs在定植和感染及其检测部位方面的性别差异。
在这项多中心回顾性队列研究中，收集了2015年至2020年间德国赫利俄斯诊所86家医院的监测数据。按样本部位分析了以下多重耐药菌：耐甲氧西林金黄色葡萄球菌（MRSA）；肠球菌属；大肠杆菌；肺炎克雷伯菌；铜绿假单胞菌；以及鲍曼不动杆菌。
在数据库中的7,081,708例病例中，发现187,656例患者定植有MDROs（2.65%）。33,023例患者被确诊感染MDROs（0.466%），其中24,231例感染源已知。男性是感染和定植任何MDROs的风险因素（P<0.001）。男性在浅表皮肤/软组织、血培养（P<0.001）和呼吸道样本中检测到MDROs的可能性更高（P=0.002）。此外，还发现了MDROs检测部位和病原体的性别差异，女性在深部皮肤/软组织和呼吸道样本中MRSA感染的比例略高。
本研究通过一个大型数据集强化了现有的假设，即男性是MDROs定植和感染的风险因素。这突出了在临床实践中认识性别特异性MDRO易感性的必要性。
