新型冠状病毒感染后3个月内的常见细菌感染：一项回顾性队列研究
Common Bacterial Infections during the 3-Month Period after SARS-CoV-2 Infection: A Retrospective Cohort Study.
作者信息
Cohen Bar, Shapiro Ben David Shirley, Rahamim-Cohen Daniella, Nakhleh Afif, Shahar Arnon, Yehoshua Ilan, Bilitzky-Kopit Avital, Azuri Joseph, Mizrahi Reuveni Miri, Adler Limor
机构信息
Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel.
The Faculty of Health Science, Ben Gurion University, Beer Sheva 8443944, Israel.
出版信息
Healthcare (Basel). 2023 Dec 12;11(24):3151. doi: 10.3390/healthcare11243151.
INTRODUCTION
Correlations between SARS-CoV-2 and bacterial infections have mainly been studied in hospitals, and these studies have shown that such interactions may be lethal for many. In the context of community flora, less is known of the trends and consequences of viral infections relative to subsequent bacterial infections.
PURPOSE
This study aims to explore the prevalence and characteristics of bacterial infections in the three months following SARS-CoV-2 infections, in a community, real-world setting.
METHODS
In this retrospective cohort study, we compared patients who completed a polymerase chain reaction (PCR) test or an antigen test for SARS-CoV-2 during January 2022, the peak of the Omicron wave, and examined bacterial infections following the test. We searched these cases for diagnoses of the following four bacterial infections for three months following the test: Group A Streptococcus (GAS) pharyngitis, pneumonia, cellulitis, and urinary tract infections (UTI).
RESULTS
During January 2022, 267,931 patients tested positive and 261,909 tested negative for SARS-CoV-2. Test-positive compared to test-negative patients were significantly younger (42.5 years old vs. 48.5 years old, < 0.001), smoked less, and had fewer comorbidities (including ischemic heart disease, diabetes mellitus, hypertension, chronic obstructive pulmonary disease, and chronic renal failure). In the multivariable analysis, test-positive patients had an increased risk for GAS pharyngitis (adjusted odds ratio [aOR] = 1.25, 95% CI 1.14-1.38, -value < 0.001) and pneumonia (aOR = 1.25, 95% CI 1.15-1.35, -value < 0.001), a trend towards an increased prevalence of UTI (aOR = 1.05, 95% CI 0.99-1.12, -value = 0.092), and lower risk for cellulitis (aOR = 0.92, 95% CI 0.86-0.99, -value < 0.05).
CONCLUSIONS
A history of SARS-CoV-2 infection in the past three months increased susceptibility to respiratory tract bacterial infections and the prevalence of UTI.
引言
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）与细菌感染之间的相关性主要在医院中进行了研究，这些研究表明，这种相互作用可能对许多人是致命的。在社区菌群的背景下，相对于随后的细菌感染，病毒感染的趋势和后果了解较少。
目的
本研究旨在探讨在社区真实环境中，SARS-CoV-2感染后三个月内细菌感染的患病率和特征。
方法
在这项回顾性队列研究中，我们比较了在2022年1月奥密克戎毒株流行高峰期完成SARS-CoV-2聚合酶链反应（PCR）检测或抗原检测的患者，并检查检测后的细菌感染情况。我们在这些病例中搜索检测后三个月内以下四种细菌感染的诊断：A组链球菌（GAS）咽炎、肺炎、蜂窝织炎和尿路感染（UTI）。
结果
2022年1月期间，267931例患者SARS-CoV-2检测呈阳性，261909例检测呈阴性。与检测阴性的患者相比，检测阳性的患者明显更年轻（42.5岁对48.5岁，<0.001），吸烟较少，合并症也较少（包括缺血性心脏病、糖尿病、高血压、慢性阻塞性肺疾病和慢性肾衰竭）。在多变量分析中，检测阳性的患者患GAS咽炎的风险增加（调整后的优势比[aOR]=1.25，95%置信区间1.14-1.38，P值<0.001）和肺炎的风险增加（aOR=1.25，95%置信区间1.15-1.35，P值<0.001），UTI患病率有增加趋势（aOR=1.05，95%置信区间0.99-1.12，P值=0.092），蜂窝织炎风险降低（aOR=0.92，95%置信区间0.86-0.99，P值<0.05）。
结论
过去三个月内有SARS-CoV-2感染史会增加呼吸道细菌感染的易感性和UTI的患病率。
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