Gender Differences on Prevalence of Uropathogens and Their Antimicrobial Resistance: Results from a Single-Center Study in Peja Region, Kosovo

Background: Urinary tract infection (UTI) is the world’s second most common bacterial infection, behind respiratory tract infections, affecting people of all ages worldwide. It is the most common bacterial infection among females. The present study aimed to determine the local bacterial species distribution of UTI isolates between males and females in the Peja region. Methods and Results: This cohort longitudinal, prospective-retrospective study was conducted in the microbiological laboratories of Peja region, Kosovo. The research includes all urine samples tested for gram-negative bacteria during three years, 2018-2020. The comparison of male and female samples in terms of the type of bacteria isolated showed that the urinary infection in female patients was caused by E. coli, significantly more often than in male patients (86.31% vs. 62.87%, P=0.0000), while in the samples from male patients, Klebsiella spp. (12.05% vs. 3.68%, P=0.0000), P. aeruginosa (7.49% vs. 1.59%, P=0.0000), and Acinetobacter spp. (7.82% vs. 1.59%, P=0.0000), were detected significantly more often than female isolates. The prevalence of Proteus spp. was similar in male and female isolates (6.19% vs. 5.03%, P=0.3926). The results of the statistical analysis showed a statistically significant difference in the resistance of E. coli to the analyzed antibiotics depending on the gender of the patients. E. coli showed significantly higher resistance in male patients than in female patients to 12 of the 13 antibiotics that were used: ampicillin, amikacin, gentamicin, cefalexin, cefuroxime, cefotaxime, ceftazidime, ofloxacin, imipenem, piperacillin, nitrofurantoin, and trimethoprim/sulfamethoxazole. In both genders, E. coli showed the lowest resistance to imipenem and the highest resistance to ampicillin. Conclusion: Not only does the prevalence of uropathogens gram-negative bacteria differ by gender (greater frequency among women) but their antibiotic resistance also differs by gender (higher resistance among male patients).