Friday, December 18, 2015

Staphylococcal Colonization and Bacteremia- Not Equal Opportunity

Methicillin-resistant Staphylococcus aureus (MRSA) is not an equal opportunity pathogen. This intriguing article published in Clinical Infectious Diseases highlights gender differences in MRSA bacteremia.


MRSA carriage and bloodstream infection (BSI) shows a male predominance, Males are more prone to bacterial sepsis, but some studies suggest females may have a poorer prognosis from MRSA BSI. 

Why? 

Per the authors, hand-hygiene behavior varies according to gender. Males are less compliant, which in turn may predispose them to higher colonization and infection rates. Nose picking may also have a male gender predilection.  Female hormones such as estrogen affect the expression of virulence factors in Pseudomonas aeruginosa. This may also apply to S. aureus. The reasons are not all that clear.

I am not sure how this translates into new prevention or treatment strategies for MRSA bacteremia. Perhaps specialized hand hygiene campaigns can focus on at risk groups (men)?  Treatment for MRSA bacteremia is likely not to be tailored to gender without more convincing clinical data.

The purported gender differences in MRSA colonization and bacteremia, albeit interesting, may not lend themselves to practical interventions.

 Vexing.

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