Gender-Based Differences in Antibiotic Resistance Profiles of Multidrug-Resistant Pseudomonas aeruginosa Isolates from a Nigerian Tertiary Hospital: A Comparative Statistical Analysis
Faith Onyinyechi Agwu
Department of Microbiology, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.
Chidinma Stacy Iroha
Department of Pharmacy, Institute of Emerging and Re-emerging Infectious Diseases Research, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Adaora Lynda Onoura
Department of Microbiology, Federal University of Allied Health Sciences, Enugu State, Nigeria.
Ikemesit Udeme Peter *
Department of Microbiology, Federal University of Allied Health Sciences, Enugu State, Nigeria and Department of Public Health, Federal University of Allied Health Sciences, Enugu State, Nigeria.
Ifeanyichukwu Romanus Iroha
Department of Microbiology, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Pseudomonas aeruginosa is a leading cause of multidrug-resistant (MDR) hospital-acquired urinary tract infections (UTIs). Despite growing recognition of gender as a determinant of health outcomes, limited research has systematically examined gender-based differences in antibiotic resistance profiles among bacterial pathogens.
Aim: This study compared antibiotic resistance patterns of MDR P. aeruginosa isolated from urine samples of male and female patients at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.
Methods: A total of 123 P. aeruginosa isolates from urine specimens (42 male, 81 female) were identified using standard microbiological methods. Antibiotic susceptibility was determined by the Kirby-Bauer disc diffusion method and the Multiple Antibiotic Resistance Index (MARI) was calculated for each isolate. Data were analyzed using SPSS version 25, with Chi-square test for gender comparisons (p<0.05 considered significant).
Results: Female isolates exhibited significantly higher resistance rates compared to male isolates for multiple antibiotics: amoxicillin-clavulanic acid (98.8 % vs. 71.4 %, p=0.0001), ciprofloxacin (96.3 % vs. 81.0 %, p=0.012), colistin (91.4 % vs. 71.4 %, p=0.007), and trimethoprim-sulfamethoxazole (95.1 % vs. 76.2 %, p=0.003). Conversely, male isolates showed significantly higher susceptibility to piperacillin-tazobactam (100 % vs. 81.5 %, p=0.009). Both genders exhibited universal resistance (100 %) to aztreonam, ceftazidime, cefotaxime, cefoxitin, and ertapenem. Mean MARI was significantly higher in female isolates (0.76 ± 0.10) compared to male isolates (0.68 ± 0.14) (p=0.031). All 123 isolates (100 %) were multidrug-resistant, with female isolates more frequently exhibiting drug-resistant phenotypes (34.6 % vs. 19.0 %).
Conclusion: Significant gender-based differences exist in antibiotic resistance profiles of MDR P. aeruginosa uropathogens, with females demonstrating broader resistance spectra and higher resistance to clinically important antibiotics including last-resort agents. These findings underscore the need for gender-informed antimicrobial stewardship, targeted empirical treatment guidelines, and gender-stratified resistance surveillance.
Keywords: Pseudomonas aeruginosa, gender differences, antibiotic resistance, multidrug resistance, urinary tract infection, Nigeria