Sensitivity of <>iStreptococcus pneumoniae to antibiotics and the sex of the patient: A systematic review and meta-analysis

BACKGROUND: The spread of microbial resistance to antibiotics is a recent global problem, which has become more acute in recent years because of a significant increase in the consumption of antibiotics, against the background of the COVID-19 pandemic. A direct consequence of the spread of antibiotic-insensitive strains of pneumococci limits the treatment options for such patients and deterioration of the prognosis. AIM: To determine whether sex is a factor associated with the development of diseases caused by antibiotic-resistant strains of Streptococcus pneumoniae. MATERIALS AND METHODS: Using the electronic databases PubMed, ScienceDirect, and Google Scholar, a search was conducted for articles published from January 1980 to December 2020, and studies in English and Russian were selected. The selection of articles and meta-analysis was based on the recommendations of the PRISMA Group and MOOSE. After combining the data, the odds ratio (OR) was calculated with a 95% confidence interval (95% CI). Heterogeneity was assessed. RESULTS: After applying the exclusion criteria, 41 publications covering 16635 patients with invasive and non-invasive forms of pneumococcal infection were selected for analysis. Of these, 36 case-control studies and 5 cross-sectional studies were identified. Accordingly, the sex of the patient does not affect the frequency of isolation of pneumococcal strains insensitive to penicillin (odds ratio [OR]=0.92, 95% confidence interval [CI] 0.821.03, I2=7%), resistant to penicillin (OR=0.85, 95% CI 0.671.07, I2=1%), and insensitive to erythromycin (OR=0.80, 95% CI 0.511.24, I2=0%). Male sex is associated with pneumococcal resistance to levofloxacin (OR=1.85, 95% CI 1.033.33, I2=0%). CONCLUSIONS: The sex of the patient is not a factor associated with the isolation of S. pneumonia strains insensitive and resistant to penicillin and erythromycin. Moreover, the male sex probably increases the chance of isolation of levofloxacin-resistant pneumococci in adults with invasive pneumococcal infections.