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More countries must recognize how gender affects exposure to pathogens, finds a review by the World Health Organization

Women might be more likely to develop drug-resistant infections than men — an under-recognized aspect of the growing threat of antimicrobial resistance, according to a global review led by the World Health Organization (WHO). The report finds that more than 70% of countries do not recognize gender inequalities in national plans to tackle drug-resistant infections.

And last month, the WHO added four pathogens to its list of the drug-resistant bacteria it considers to be most dangerous to humans. The list, first published in 2017, helps nations to shape their action plans against antimicrobial resistance (AMR), which is caused by the overuse and misuse of antibiotics that leads to bacteria becoming resistant to the medications through mutations in their DNA.

The changes to the list were based on how commonly the bacteria cause infections, their deadliness and how easily infections can be prevented through measures such as handwashing, quarantine and vaccination. The WHO added three streptococcal bacteria — which cause conditions including a type of pneumonia and an influenza-like infection that can be fatal in extreme cases — and a highly resistant variety of tuberculosis (see ‘Dangerous drug resistance’). The streptococci are linked to a high burden of disease, especially in poor countries, and the tuberculosis strain is difficult to detect and very expensive to treat.