Department of General Practice, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Street, Chongqing, 402160, China.
Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
Sci Rep. 2024 Jun 3;14(1):12737. doi: 10.1038/s41598-024-62728-2.
The COVID-19 pandemic has altered the infection landscape for many pathogens. This retrospective study aimed to compare Haemophilus influenzae (H. influenzae) infections in pediatric CAP patients hospitalized before (2018-2019) and during (2020-2022) the COVID-19 pandemic. We analyzed the clinical epidemiology and antimicrobial resistance (AMR) patterns of H. influenzae from a tertiary hospital in southwest China. A total of 986 pediatric CAP patients with H. influenzae-associated infections were included. Compared to 2018, the positivity rate increased in 2019 but dropped significantly in 2020. Although it rose in the following 2 years, the rate in 2022 remained significantly lower than in 2019. Patients' age during the pandemic was significantly higher than in 2018 and 2019, while gender composition remained similar across both periods. Notably, there were significant changes in co-infections with several respiratory pathogens during the pandemic. Resistance rates of H. influenzae isolates to antibiotics varied, with the highest resistance observed for ampicillin (85.9%) and the lowest for cefotaxime (0.0%). Resistance profiles to various antibiotics underwent dramatic changes during the COVID-19 pandemic. Resistance to amoxicillin-clavulanate, cefaclor, cefuroxime, trimethoprim-sulfamethoxazole, and the proportion of multi-drug resistant (MDR) isolates significantly decreased. Additionally, MDR isolates, alongside isolates resistant to specific drugs, were notably prevalent in ampicillin-resistant and β-lactamase-positive isolates. The number of pediatric CAP patients, H. influenzae infections, and isolates resistant to certain antibiotics exhibited seasonal patterns, peaking in the winter of 2018 and 2019. During the COVID-19 pandemic, sharp decreases were observed in February 2020, and there was no resurgence in December 2022. These findings indicate that the COVID-19 pandemic has significantly altered the infection spectrum of H. influenzae in pediatric CAP patients, as evidenced by shifts in positivity rate, demographic characteristics, respiratory co-infections, AMR patterns, and seasonal trends.
COVID-19 大流行改变了许多病原体的感染格局。本回顾性研究旨在比较 COVID-19 大流行前后（2018-2019 年和 2020-2022 年）住院的小儿 CAP 患者中流感嗜血杆菌（H. influenzae）感染的情况。我们分析了中国西南部一家三级医院的流感嗜血杆菌的临床流行病学和抗菌药物耐药性（AMR）模式。共纳入 986 例小儿 CAP 合并 H. influenzae 感染患者。与 2018 年相比，2019 年阳性率增加，但 2020 年显著下降。尽管在随后的 2 年中有所上升，但 2022 年的阳性率仍明显低于 2019 年。大流行期间患者的年龄明显高于 2018 年和 2019 年，而性别构成在两个时期保持相似。值得注意的是，大流行期间与几种呼吸道病原体的合并感染发生了显著变化。流感嗜血杆菌分离株对抗生素的耐药率不同，其中对氨苄西林的耐药率最高（85.9%），对头孢噻肟的耐药率最低（0.0%）。在 COVID-19 大流行期间，各种抗生素的耐药谱发生了显著变化。对阿莫西林-克拉维酸、头孢克洛、头孢呋辛、复方磺胺甲噁唑的耐药率以及多重耐药（MDR）分离株的比例显著降低。此外，在氨苄西林耐药和产β-内酰胺酶的分离株中，MDR 分离株和对特定药物耐药的分离株明显更为常见。儿科 CAP 患者数量、流感嗜血杆菌感染和某些抗生素耐药分离株呈季节性模式，2018 年和 2019 年冬季达到高峰。COVID-19 大流行期间，2020 年 2 月急剧下降，2022 年 12 月没有复燃。这些发现表明，COVID-19 大流行显著改变了小儿 CAP 患者中流感嗜血杆菌的感染谱，表现在阳性率、人口统计学特征、呼吸道合并感染、AMR 模式和季节性趋势的变化。
