Dai Yanping, Tao Shuan, Ying Huanhuan, Fang Qianqian, Kong Jingping, Guo Fei, Yang Yong, Cao Peng, Zhou Ying, Jin Weijiang, Liang Wei
Department of Laboratory Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
Department of Clinical Laboratory, The First Affiliated Hospital of Ningbo University, Ningbo, 315010, Zhejiang, China.
BMC Infect Dis. 2024 Dec 19;24(1):1451. doi: 10.1186/s12879-024-10347-7.
This study aims to investigate the prevalence, pathogen spectrum, clinical characteristics, and prognosis-related factors of other respiratory pathogens in COVID-19-infected patients, and to explore the application of molecular detection methods in the epidemiological investigation of multiple pathogen infections.
Respiratory samples and clinical data from 384 patients with outpatient and inpatient respiratory infections were collected and analyzed. Multiplex PCR and capillary electrophoresis were conducted to detect the distribution characteristics of 26 pathogen species, comprising 13 viruses, 13 bacteria. Statistical analysis explored the relationship between pathogen distribution with COVID-19 development.
There was no statistical difference in prognosis between the 230 COVID-19-positive patients and the 154 COVID-19-positive patients. COVID-19 cases co-infected with other pathogens do not correlate with patient's age and gender. The main distribution of pathogens was mainly mecA (n = 62, 26.96%), followed by SPN(n = 61; 26.52%) and KP(n = 22; 9.57%). Compared with non-COVID-19 cases, COVID-19 infected patients showed a significantly higher mecA carrying rate (26.96% vs. 15.58%, P < 0.01), while there was no statistical difference for other pathogens. Regression analysis found that mecA and KP were independent risk factors for severe illnesses (mechanical ventilation, endotracheal intubation, ECOMO, etc.) or death in COVID-19 patients had 2.391 times and 3.722 times risk of severe disease or death compared with COVID-19 patients without mecA and KP.
COVID-19 patients show a higher mecA carrier rate than non-COVID-19 patients, and mecA and KP may increase the risk of severe disease or death in COVID-19 patients, which requires close attention.
本研究旨在调查新型冠状病毒肺炎（COVID-19）感染患者中其他呼吸道病原体的流行情况、病原体谱、临床特征及预后相关因素，并探讨分子检测方法在多种病原体感染流行病学调查中的应用。
收集并分析384例门诊及住院呼吸道感染患者的呼吸道样本和临床资料。采用多重聚合酶链反应（PCR）和毛细管电泳检测13种病毒和13种细菌共26种病原体的分布特征。通过统计分析探讨病原体分布与COVID-19病情发展的关系。
230例COVID-19阳性患者和154例COVID-19阴性患者的预后无统计学差异。COVID-19合并其他病原体感染的病例与患者年龄和性别无关。病原体主要分布为耐甲氧西林金黄色葡萄球菌（mecA，n = 62，26.96%），其次为肺炎链球菌（SPN，n = 61；26.52%）和肺炎克雷伯菌（KP，n = 22；9.57%）。与非COVID-19病例相比，COVID-19感染患者的mecA携带率显著更高（26.96%对15.58%，P < 0.01），而其他病原体无统计学差异。回归分析发现，mecA和KP是COVID-19患者发生重症（机械通气、气管插管、体外膜肺氧合等）或死亡的独立危险因素，与未感染mecA和KP的COVID-19患者相比，感染mecA和KP的患者发生重症或死亡的风险分别高2.391倍和3.722倍。
COVID-19患者的mecA携带率高于非COVID-19患者，mecA和KP可能增加COVID-19患者发生重症或死亡的风险，需密切关注。
