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Stavar-Matei L, Mihailov OM, Nechita A, Crestez AM, Tocu G. Impact of COVID-19 on Pneumococcal Acute Otitis Media, Antibiotic Resistance, and Vaccination in Children. Infect Drug Resist 2024; 17:5567-5578. [PMID: 39691490 PMCID: PMC11651131 DOI: 10.2147/idr.s496057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 11/05/2024] [Indexed: 12/19/2024] Open
Abstract
Streptococcus pneumoniae is the main pathogen that plays a dual role, on the one hand as an asymptomatic carrier in the nasopharyngeal mucosa and on the other hand directly responsible for triggering invasive pneumococcal infections with various important localizations, especially in the pediatric population. Thus, invasive pneumococcal infections represent one of the main causes of mortality and morbidity in children under 5 years of age. Immunization is a key preventive measure against these infections. The evolution of these infections caused by S. pneumoniae is influenced both directly and indirectly by several factors: the immunization status of the patient, the regional and seasonal distribution of pneumococcal serotypes, susceptibility to anti-biotics, the existence of viral or bacterial co-infections and the socio-economic conditions specific to each region. This review gathers the current open-access PubMed evidence on the incidence of invasive pneumococcal infections and their susceptibility to antibiotics in the 0-5 age group during and after the COVID-19 pandemic. We have chosen this association with the SARS-COV- 2 virus because this pandemic has caused major changes on all personal, social, professional, and medical levels worldwide. Both pneumococcal disease and COVID-19 have similar risk factors, and S. pneumoniae was one of the most common co-infecting agents during the COVID-19 pandemic. The attention was focused on 8 clinical trials published in the pre- and post COVID-19 period that had as main subject acute otitis media caused by Streptococcus pneumoniae in children aged 0-5 years. The studies were collected from different geographical regions, both from socio-economically developed and developing countries such as Niger, Malawi, China and Papua New Guinea, Japan, Australia, Italy, in order to have a global overview. In conclusion, the COVID-19 pandemic had a major impact on the quality of life of pediatric patients diagnosed with pneumococcal acute otitis media both in terms of non-vaccine serotypes and antimicrobial resistance.
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Affiliation(s)
- Loredana Stavar-Matei
- Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
- Sf. Ioan” Children’s Clinical Emergency Hospital, Galati, Romania
| | - Oana-Mariana Mihailov
- Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
- Pneumophthiology Hospital, Galati, Romania
| | - Aurel Nechita
- Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
- Sf. Ioan” Children’s Clinical Emergency Hospital, Galati, Romania
| | - Alexandra Mihaela Crestez
- Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
- Sf. Ioan” Children’s Clinical Emergency Hospital, Galati, Romania
| | - George Tocu
- Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
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Bondi A, Koumantakis E, Curtoni A, Barbui AM, Peradotto M, Lombardi D, Casale R, Alizzi S, Zanotto E, Charrier L, Cavallo R, Costa C. Epidemiology and Impact of Anti-Pneumococcal Vaccination and COVID-19 on Resistance of Streptococcus pneumoniae Causing Invasive Disease in Piedmont, Italy. Antibiotics (Basel) 2024; 13:740. [PMID: 39200039 PMCID: PMC11350834 DOI: 10.3390/antibiotics13080740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND The international surveillance of antimicrobial resistance (AMR) reports S. pneumoniae as one of leading causes of death associated with AMR. Against invasive disease, several vaccinations are available and a reduction in AMR in S. pneumoniae has been observed. Here, we evaluated the impact of anti-pneumococcal vaccination policy and the SARS-CoV2 outbreak on AMR in S. pneumoniae causing invasive disease. METHODS We collected all strains of S. pneumoniae causing invasive disease from 2008 in the Piedmont region (Italy). Each strain was typed in order to identify the serogroup and data about AMR were collected. The population under surveillance was classified as infants, children, adults, and the old population. RESULTS We collected n = 2076 S. pneumoniae strains, with 21.9% and 40.3% being resistant to penicillin G and erythromycin, respectively. We reported an increased risk of infection with penicillin-resistant S. pneumoniae among all populations and evaluated whether the infection was caused by a serotype included in the vaccine formulation. A similar increase was observed after the SARS-CoV2 outbreak. CONCLUSIONS In the Piedmont region, subsequently to the introduction of anti-pneumococcal vaccination, a significant increase in the risk of penicillin G-resistant invasive pneumococcal disease among infants and old population was reported. No significant impact was found for the SARS-CoV2 outbreak.
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Affiliation(s)
- Alessandro Bondi
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
| | - Emanuele Koumantakis
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
- Post Graduate School of Medical Statistics, University of Turin, 10126 Turin, Italy
| | - Antonio Curtoni
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
| | - Anna Maria Barbui
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
| | - Marco Peradotto
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
| | - Daniela Lombardi
- Regional Epidemiology Reference Service for the Surveillance, Prevention and Control of Infectious Disease (SeREMI), 15121 Alessandria, Italy;
| | - Roberto Casale
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
| | - Silvia Alizzi
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
| | - Elisa Zanotto
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
| | - Lorena Charrier
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
| | - Rossana Cavallo
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
| | - Cristina Costa
- Microbiology and Virology Unit, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (A.B.); (A.C.); (A.M.B.); (M.P.); (S.A.); (R.C.)
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.K.); (R.C.); (L.C.)
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Fedeli U, Barbiellini Amidei C, Tacconelli E, Carrara E. Sepsis-related mortality: long-term trends in Northeastern Italy, including pandemic years. Infect Dis (Lond) 2024; 56:624-631. [PMID: 38607235 DOI: 10.1080/23744235.2024.2340728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Global estimates of sepsis mortality are based on multiple causes of death (MCOD, any mention of the condition on death certificates); however, MCOD data are sparse and mainly referring to the pre-pandemic period. OBJECTIVES To investigate recent trends in sepsis-related mortality, associated sites of infection, and comorbidities in Veneto (Northeastern Italy). METHODS Mortality records from 2008 to 2022 were extracted, and sepsis-related mortality was assessed based both on the underlying cause of death (UCOD) and on MCOD. The average annual percent change in age-standardised rates was estimated by join point regression through the whole study period. MCOD records were investigated to retrieve infection sites and comorbidities. RESULTS Sepsis was mentioned in 63,479 death certificates, growing from 4.9% out of all deaths in 2008 to 12.9% in 2022. Age-standardised mortality rates increased yearly by 8.2% (95%CI 2.1-14.7%) based on the UCOD and by 5.9% (95%CI 5.3-6.5%) based on MCOD. Sharp peaks in monthly mortality were observed in correspondence with flu epidemics, COVID-19 pandemic waves, and periods of extreme heat. The percentage of sepsis-related deaths associated to urinary tract infections, and with mention of neurodegenerative disorders and chronic kidney disease increased over time. CONCLUSION Raised awareness of physicians, ageing of the population, spread of antimicrobial resistance further fuelled by the COVID-19 pandemic are among reasons of increasing sepsis-related mortality in Italy. Continuous monitoring of sepsis by means of MCOD data and other surveillance tools is warranted.
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Affiliation(s)
- Ugo Fedeli
- Epidemiological Department, Azienda Zero, Padova, Italy
| | | | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Elena Carrara
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
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Ai L, Fang L, Liu B, Zhou C, Gong F. Impact of the COVID-19 pandemic on Haemophilus influenzae infections in pediatric patients hospitalized with community acquired pneumonia. Sci Rep 2024; 14:12737. [PMID: 38830922 PMCID: PMC11148099 DOI: 10.1038/s41598-024-62728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024] Open
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.
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Affiliation(s)
- Ling Ai
- 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
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Liang Fang
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Beizhong Liu
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Department of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Chanjuan Zhou
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Fang Gong
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Street, Chongqing, 402160, China.
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
- Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
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Invasive Meningococcal Disease and Meningococcal Serogroup B Vaccination in Adults and Their Offspring: Knowledge, Attitudes, and Practices in Italy (2019). Vaccines (Basel) 2023; 11:vaccines11030508. [PMID: 36992092 DOI: 10.3390/vaccines11030508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/05/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Despite its effectiveness in preventing invasive meningococcal disease (IMD), pediatric uptake of recombinant meningococcal vaccination for serogroup B meningitis (MenB) is low in Italy. This study aimed to investigate knowledge, attitudes, and practice (KAP) about IMD and the vaccine uptake for MenB from July to December 2019, in a sample collected from a series of local Facebook discussion groups from the provinces of Parma and Reggio Emilia (North-Eastern Italy; 337,104 registered users). A self-administered anonymous web-based questionnaire was used to collect demographics, knowledge status, perceived risk for contracting meningitis, attitude towards the utility of meningococcal vaccine, and willingness to receive/perform MenB vaccine in their offspring. In total, 541 parents returned a fully completed questionnaire (response rate of 1.6% of potential recipients), with a mean age of 39.2 years ± 6.3 (78.1% females). Meningococcal infection was identified as severe or highly severe by most participants (88.9%), while it was recognized as being frequent/highly frequent in the general population by 18.6% of respondents. The overall knowledge status was unsatisfactory (57.6% ± 33.6 of correct answers to the knowledge test). Even though 63.4% of participants were somewhat favorable to MenB/MenC vaccines, offspring’s vaccination towards MenB was reported by only 38.7% of participants. In a binary logistic regression model, the male gender of respondents (adjusted odds ratio [aOR] 3.184, 95% confidence interval [95%CI] 1.772 to 5.721), living in a municipality >15,000 inhabitants (aOR 1.675, 95%CI 1.051 to 2.668), reporting a favorable attitude on meningococcus B vaccine (aOR 12.472, 95%CI 3.030 to 51.338), having been vaccinated against serogroup B (aOR 5.624, 95%CI 1.936 to 16.337) and/or serogroup C (aOR 2.652, 95%CI 1.442 to 4.872), and having previously vaccinated their offspring against serogroup C meningococcus (aOR 6.585, 95%CI 3.648 to 11.888) were characterized as positive effectors of offspring’s vaccination. On the contrary, having a higher risk perception on vaccines was identified as the only negative effector (aOR 0.429, 95%CI 0.241 to 0.765). Our results hint towards extensive knowledge gaps on IMD and preventive interventions in the general population, suggesting that a positive attitude towards vaccines and vaccinations could be identified as the main effector also for MenB acceptance. Interventions in the general population aimed at improving confidence, compliance, and acknowledgment of the collective responsibility, as well as preventing actual constraints and the sharing of false beliefs on infectious diseases and their preventive measures, could therefore increase vaccination acceptance in both targeted individuals and their offspring.
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Völk S, Ködel U, Pfister HW, Klein M. [Influence of the COVID-19 pandemic on the occurrence of neurological infectious diseases]. DER NERVENARZT 2022; 94:278-286. [PMID: 36576523 PMCID: PMC9795461 DOI: 10.1007/s00115-022-01420-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic a wide range of hygiene measures were implemented to contain the spread of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Besides a mitigation of SARS-CoV‑2, a decline in the number of other respiratory tract infections could be observed. Interestingly, the numbers for some infections of the central nervous system (CNS) decreased as well. OBJECTIVE This review article shows the development of important CNS infections in Germany during the COVID-19 pandemic. MATERIAL AND METHOD This article is based on relevant literature on the epidemiology of CNS infections during the COVID-19 pandemic up to autumn 2022. RESULTS During the COVID-19 pandemic the frequency of bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae significantly declined. The frequency of viral meningitis, particularly those caused by Enterovirus, decreased as well. In contrast, the number of patients suffering from tick-borne encephalitis significantly increased within the first year of the pandemic. DISCUSSION During the pandemic there was a decrease in cases of bacterial and viral meningitis, most likely due to the general containment strategies and social contact restrictions. The increase of infections transmitted by ticks could be a consequence of changed leisure activities during the pandemic.
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Affiliation(s)
- Stefanie Völk
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, LMU München, Marchioninistraße 15, 81377, München, Deutschland
| | - Uwe Ködel
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, LMU München, Marchioninistraße 15, 81377, München, Deutschland
| | - Hans-Walter Pfister
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, LMU München, Marchioninistraße 15, 81377, München, Deutschland
| | - Matthias Klein
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, LMU München, Marchioninistraße 15, 81377, München, Deutschland.
- Zentrale Notaufnahme, Klinikum der Universität München, LMU München, München, Deutschland.
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