新型冠状病毒肺炎公共卫生限制措施对中国河南儿童社区获得性肺炎病原体的影响：一项多中心回顾性研究

Influence of COVID-19 public health restrictions on community-acquired pneumonia pathogens in children in Henan, China: a multicenter retrospective study.

作者信息

Guo Yalin, Yang Debin, Cao Yang, Ding Xianfei, Chen LiXia, Huo Beibei, Li Yuanzhe

机构信息

Department of Pediatrics, Children's Hospital Affiliated to Zhengzhou University, No.33 Long hu Wai huan East Road, Zhengzhou, Henan, 450018, China.

Department of Pediatrics, The General Hospital of Jinshui District Zhengzhou City, Zhengzhou, 450000, China.

出版信息

BMC Infect Dis. 2024 Dec 3;24(1):1381. doi: 10.1186/s12879-024-10268-5.

DOI:10.1186/s12879-024-10268-5

PMID:39627713

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11616279/

Abstract

OBJECTIVE

To investigate the distribution of pathogens and epidemiological changes in children hospitalized with community-acquired pneumonia (CAP) during and after the COVID-19 pandemic public health restrictive measures. aiming to provide a foundation for clinical diagnosis, treatment, and policy formulation.

METHODS

This multicenter retrospective study spanned January 2019 to December 2023. The study included 78,256 children hospitalized for CAP in four hospitals in Henan, China, among which 27,580 cases (35.2%) were tested for pathogens using multiplex real-time fluorescent polymerase chain reaction (PCR). The pathogens detected include Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), respiratory syncytial virus (RSV), influenza A virus (Flu A), influenza B virus (Flu B), and Mycoplasma pneumoniae (MP).

RESULTS

Pathogens were identified in 18,690 of the 27,580 children, resulting in a 67.8% positive detection rate. Of these cases, 15,105 (54.8%) were single pathogen infections and 3,585 (13%) were mixed pathogen infections. The pathogen positivity rate was lowest in the first year of the COVID-19 pandemic (2020), at 54.7%, and peaked at 79.1% in 2023, after public health restrictions were lifted. During the COVID-19 pandemic (2020-2022), seasonal variation in pathogen prevalence was disrupted. Post-restriction, there was a significant increase in RSV and MP cases. SP remained the leading bacterial cause of CAP, especially in young children. RSV was the predominant viral pathogen, particularly affecting infants. MP showed a rising trend with age, yet it also affected younger individuals.

CONCLUSION

The COVID-19 pandemic altered the epidemiological characteristics of pathogens in children with CAP. This impact is likely to persist, necessitating enhanced surveillance of CAP pathogens to mitigate the healthcare burden in children.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

目的

调查新型冠状病毒肺炎（COVID-19）大流行公共卫生限制措施期间及之后因社区获得性肺炎（CAP）住院儿童的病原体分布及流行病学变化，旨在为临床诊断、治疗及政策制定提供依据。

方法

本多中心回顾性研究涵盖2019年1月至2023年12月。研究纳入了中国河南四家医院78256例因CAP住院的儿童，其中27580例（35.2%）采用多重实时荧光聚合酶链反应（PCR）检测病原体。检测的病原体包括肺炎链球菌（SP）、金黄色葡萄球菌（SA）、流感嗜血杆菌（HI）、呼吸道合胞病毒（RSV）、甲型流感病毒（Flu A）、乙型流感病毒（Flu B）和肺炎支原体（MP）。

结果

27580例儿童中18690例鉴定出病原体，阳性检出率为67.8%。其中，15105例（54.8%）为单一病原体感染，3585例（13%）为混合病原体感染。病原体阳性率在COVID-19大流行的第一年（2020年）最低，为54.7%，在2023年公共卫生限制解除后达到峰值79.1%。在COVID-19大流行期间（2020 - 2022年），病原体流行的季节性变化被打乱。限制措施解除后，RSV和MP病例显著增加。SP仍然是CAP的主要细菌病因，尤其是在幼儿中。RSV是主要的病毒病原体，尤其影响婴儿。MP随年龄呈上升趋势，但也影响较年轻个体。