中国武汉 COVID-19 大流行期间新生儿菌血症流行病学的变化。

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES
Jingjing Rao, Xiaomei Wang, Shiyong Deng, Feng Tang, Changzhen Li
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引用次数: 0

摘要

目的调查早期和晚期新生儿菌血症的发病率、病原体分布和抗生素敏感性,并分析 COVID-19 大流行之前和期间的病原体趋势:方法:2016 年 1 月至 2022 年 12 月期间,我们收集了 879 份患有菌血症的新生儿血液和脑脊液标本。细菌鉴定采用生化方法和 MALDI-TOF,抗生素敏感性检测采用 VITEK 2 系统。采用威尔逊95%置信区间计算每千例入院新生儿的发病率,采用χ²检验或费雪精确检验比较分类变量:结果:早发菌血症的发病率为每千例住院患者 2.6 例,晚发菌血症的发病率为 26.3 例,在研究期间从每千例住院患者 70.7 例显著降至 10.5 例。晚发型菌血症在 COVID-19 之前更为常见,而早发型菌血症在大流行期间有所增加。发病率最高的五种病原体分别是 CoNS(39.9%)、E. faecalis(17.7%)、E. faecium(13.7%)、E. coli(8.4%)和 GBS(5.8%)。在 COVID-19 大流行期间,CoNS 和金黄色葡萄球菌感染率显著下降。在整个研究期间,CoNS 和金黄色葡萄球菌对青霉素 G 和红霉素的耐药性较高,但对万古霉素和利奈唑胺敏感。粪肠球菌和粪肠杆菌对万古霉素、利奈唑烷和替考拉宁敏感,但对红霉素、四环素和利福平耐药。分别有 72.7% 和 31.0% 的分离物检测出 MRCoNS 和 MRSA。大流行期间,粪肠球菌和粪肠杆菌对氨苄西林的耐药率显著下降,GBS 对克林霉素的耐药率也有所下降:本研究强调了 COVID-19 大流行期间新生儿菌血症模式的显著变化,这种变化很可能受到加强感染控制和产妇护理中断的影响,从而导致病原体分布和抗菌药耐药性的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changes in the epidemiology of neonatal bacteremia during the COVID-19 pandemic in Wuhan, China.

Objective: To investigate the incidence, pathogen distribution, and antibiotic susceptibility of early- and late-onset neonatal bacteremia, and to analyze pathogen trends before and during the COVID-19 pandemic.

Methods: Between January 2016 to December 2022, we collected 879 blood and cerebrospinal fluid specimens from newborns with bacteremia. Bacterial identification used biochemical methods and MALDI-TOF, and antibiotic susceptibility was tested with the VITEK 2 system. Incidence per 1,000 admissions was calculated with Wilson's 95% confidence intervals, and categorical variables were compared using χ²-test or Fisher's exact test.

Results: Early-onset bacteremia incidence was 2.6 per 1,000 admissions, and late-onset bacteremia was 26.3, with a significant decline from 70.7 to 10.5 per 1,000 admissions over the study period. Late-onset bacteremia was more common before COVID-19, while early-onset bacteremia increased during the pandemic. The top five pathogens were CoNS(39.9%), E. faecalis(17.7%), E. faecium(13.7%), E. coli(8.4%), and GBS(5.8%). During the COVID-19 pandemic, the incidence of CoNS and S. aureus infections significantly decreased. Throughout the entire study period, CoNS and S. aureus showed high resistance to penicillin G and erythromycin but were sensitive to vancomycin and linezolid. E. faecalis and E. faecium were susceptible to vancomycin, linezolid, and teicoplanin but resistant to erythromycin, tetracycline, and rifampin. MRCoNS and MRSA were detected in 72.7% and 31.0% of isolates, respectively. Resistance rates of E. faecium and E. faecalis to ampicillin decreased significantly, clindamycin resistance in GBS decreased during the pandemic.

Conclusion: This study highlights notable shifts in neonatal bacteraemia patterns during the COVID-19 Pandemic that were likely influenced by increased infection control and disruptions in maternal care, leading to changes in pathogen distribution and antimicrobial resistance.

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来源期刊
CiteScore
10.40
自引率
2.20%
发文量
138
审稿时长
1 months
期刊介绍: EJCMID is an interdisciplinary journal devoted to the publication of communications on infectious diseases of bacterial, viral and parasitic origin.
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