男性定植和感染耐多药生物的风险高于女性。

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2024-10-11 DOI:10.1016/j.jhin.2024.07.021

C. Kodde , M. Bonsignore , J. Köhler , K. Schwegmann , I. Nachtigall

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引用次数: 0

摘要

背景：全球耐多药生物体（MDRO）的增加令人担忧，抗菌药耐药性（AMR）对全球公共卫生构成了重大威胁。虽然已知某些风险因素包括最近的抗菌治疗、使用不当和住院治疗，但很少有人关注 MDRO 的性别特异性。我们的目的是显示多种 MDRO 的定植和感染及其检测部位的性别差异：在这项多中心、回顾性队列研究中，我们收集了德国赫利俄斯集团旗下 86 家医院在 2015 年至 2020 年期间的监测数据。根据采样地点对以下耐多药细菌进行了分析：MRSA、肠球菌属、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌：在数据库中的 7,081,708 个病例中，有 187,656 名患者（2.65%）感染了 MDRO。33,023名患者（0.466%）被证实感染了MDRO，其中24,231例患者的感染源是已知的。男性是感染和定植任何 MDRO 的风险因素（p< .001）。男性在表层皮肤/软组织、血液培养（p < .001）和呼吸道样本（p = .002）中检出 MDRO 的可能性更高。此外，我们还发现了MDRO检测部位和病原体的性别差异，女性在深层皮肤/软组织和呼吸道样本中感染MRSA的比例略高：我们的研究加强了现有的假设，即男性性别是MDRO的一个风险因素，我们的大型数据集也支持了这一假设。它强调了在临床实践中承认特定性别对 MDRO 易感性的必要性。

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Males are at higher risk of colonization and infection with multi-drug-resistant organisms than females

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.