Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Oct 20;90(10):e0028322.
doi: 10.1128/iai.00283-22. Epub 2022 Sep 19.

Sex and Gender Differences in Bacterial Infections

Sara P Dias  1   2   3 , Matthijs C Brouwer  1   3 , Diederik van de Beek  1   3
Affiliations
Review

Sex and Gender Differences in Bacterial Infections

Sara P Dias et al. Infect Immun. .

Abstract

There is a growing awareness of the importance of sex and gender in medicine and research. Women typically have stronger immune responses to self and foreign antigens than men, resulting in sex-based differences in autoimmunity and infectious diseases. In both animals and humans, males are generally more susceptible than females to bacterial infections. At the same time, gender differences in health-seeking behavior, quality of health care, and adherence to treatment recommendations have been reported. This review explores our current understanding of differences between males and females in bacterial diseases. We describe how genetic, immunological, hormonal, and anatomical factors interact to influence sex-based differences in pathophysiology, epidemiology, clinical presentation, disease severity, and prognosis, and how gender roles affect the behavior of patients and providers in the health care system.

Keywords: bacterial infections; gender differences; sex differences.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIG 1
FIG 1
Interaction between sex and gender in bacterial diseases.
FIG 2
FIG 2
Sex differences in immune responses associated with bacterial infection. Ig, immunoglobulin; PAMP, pathogen-associated molecular patterns; TLR, Toll-like receptor.
FIG 3
FIG 3
Sex and gender bias in bacterial infections. MSM, men who have sex with men; RTIs, respiratory tract infections; STIs, sexual transmitted infections; UTIs, urinary tract infections.
See this image and copyright information in PMC

References

    1. Giefing-Kröll C, Berger P, Lepperdinger G, Grubeck-Loebenstein B. 2015. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell 14:309–321. 10.1111/acel.12326. - DOI - PMC - PubMed
    1. Shannon G, Jansen M, Williams K, Cáceres C, Motta A, Odhiambo A, Eleveld A, Mannell J. 2019. Gender equality in science, medicine, and global health: where are we at and why does it matter? Lancet 393:560–569. 10.1016/S0140-6736(18)33135-0. - DOI - PubMed
    1. Fish EN. 2008. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol 8:737–744. 10.1038/nri2394. - DOI - PMC - PubMed
    1. Tukiainen T, Villani A-C, Yen A, Rivas MA, Marshall JL, Satija R, Aguirre M, Gauthier L, Fleharty M, Kirby A, Cummings BB, Castel SE, Karczewski KJ, Aguet F, Byrnes A, GTEx Consortium, Lappalainen T, Regev A, Ardlie KG, Hacohen N, MacArthur DG. 2017. Landscape of X chromosome inactivation across human tissues. Nature 550:244–248. 10.1038/nature24265. - DOI - PMC - PubMed
    1. Souyris M, Cenac C, Azar P, Daviaud D, Canivet A, Grunenwald S, Pienkowski C, Chaumeil J, Mejía JE, Guéry J-C. 2018. TLR7 escapes X chromosome inactivation in immune cells. Sci Immunol 3:eaap8855. 10.1126/sciimmunol.aap8855. - DOI - PubMed

Publication types