PDF(Pubmed)
Abstract：
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.
摘要：
COVID-19大流行改变了许多病原体的感染格局。这项回顾性研究旨在比较流感嗜血杆菌(H.在COVID-19大流行之前（2018-2019年）和期间（2020-2022年）住院的小儿CAP患者的流感）感染。我们分析了中国西南某三级医院流感嗜血杆菌的临床流行病学和耐药性（AMR）模式。共纳入986例流感嗜血杆菌相关感染的儿科CAP患者。与2018年相比，2019年的阳性率有所上升，但在2020年大幅下降。尽管在接下来的两年里有所上升，率，2022年仍较2019年大幅下降。大流行期间的患者年龄明显高于2018年和2019年，而这两个时期的性别构成保持相似。值得注意的是,大流行期间,几种呼吸道病原体的共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各不相同，氨苄青霉素耐药率最高(85.9%)，头孢噻肟耐药率最低(0.0%)。在COVID-19大流行期间，对各种抗生素的耐药性发生了巨大变化。对阿莫西林-克拉维酸的抗性，头孢克洛,头孢呋辛,甲氧苄啶-磺胺甲恶唑,多重耐药（MDR）分离株的比例显着下降。此外,MDR分离株,除了对特定药物有抗性的分离株，在氨苄青霉素耐药和β-内酰胺酶阳性的分离株中尤为普遍。儿科CAP患者的数量，流感嗜血杆菌感染，对某些抗生素耐药的分离株表现出季节性模式，在2018年和2019年的冬季达到顶峰。在COVID-19大流行期间，2020年2月观察到急剧下降，2022年12月没有复苏。这些结果表明，COVID-19大流行显著改变了儿童CAP患者流感嗜血杆菌的感染谱，正如阳性率的变化所证明的那样，人口特征，呼吸道共感染,AMR模式,和季节性趋势。
