The Epidemiology of Pathogens in Community-Acquired Pneumonia Among Children in Southwest China Before, During and After COVID-19 Non-pharmaceutical Interventions: A Cross-Sectional Study

IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Influenza and Other Respiratory Viruses Pub Date : 2024-08-15 DOI:10.1111/irv.13361
Ruling Yang, Hongmei Xu, Zhenzhen Zhang, Quanbo Liu, Ruiqiu Zhao, Gaihuan Zheng, Xiaoying Wu
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Abstract

Objective

This study aimed to investigate the pathogen epidemiology of community-acquired pneumonia (CAP) among children in Southwest China before, during and after the COVID-19 non-pharmaceutical interventions (NPIs).

Methods

Pathogen data of hospitalised children with CAP, including multiple direct immunofluorescence test for seven viruses, bacterial culture and polymerase chain reaction (PCR) for Mycoplasma pneumoniae, were analysed across three phases: Phase I (pre-NPIs: 1 January 2019 to 31 December 2019), Phase II (NPI period: 1 January 2020 to 31 December 2020) and Phase III (post-NPIs: 1 January 2023 to 31 December 2023).

Results

A total of 7533 cases were enrolled, including 2444, 1642 and 3447 individuals in Phases I, II and III, respectively. M. pneumoniae predominated in Phases I and III (23.4% and 35.5%, respectively). In Phase II, respiratory syncytial virus (RSV) emerged as the primary pathogen (20.3%), whereas detection rates of influenza A virus (Flu A) and M. pneumoniae were at a low level (1.8% and 9.6%, respectively). In Phase III, both Flu A (15.8%) and M. pneumoniae epidemic rebounded, whereas RSV detection rate returned to Phase I level, and detection rates of Streptococcus pneumoniae and Haemophilus influenzae decreased significantly compared to those in Phase I. Detection rates of adenovirus and parainfluenza virus type 3 decreased phase by phase. Age-stratified analysis and monthly variations supported the above findings. Seasonal patterns of multiple pathogens were disrupted during Phases II and III.

Conclusions

COVID-19 NPIs exhibited a distinct impact on CAP pathogen epidemic among children, with post-NPIs increases observed in M. pneumoniae and Flu A prevalence. Continuous pathogen monitoring is crucial for effective prevention and control of paediatric CAP.

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中国西南地区儿童社区获得性肺炎病原体在 COVID-19 非药物干预前、干预期间和干预后的流行病学:一项横断面研究。
研究目的本研究旨在调查中国西南地区儿童社区获得性肺炎(CAP)在COVID-19非药物干预(NPIs)之前、期间和之后的病原体流行病学:分析了三个阶段的住院儿童 CAP 病原体数据,包括七种病毒的多重直接免疫荧光检测、细菌培养和肺炎支原体聚合酶链反应(PCR):第一阶段(NPI 前:2019 年 1 月 1 日至 2019 年 12 月 31 日)、第二阶段(NPI 期:2020 年 1 月 1 日至 2020 年 12 月 31 日)和第三阶段(NPI 后:2023 年 1 月 1 日至 2023 年 12 月 31 日):第一、第二和第三阶段共纳入 7533 个病例,分别为 2444 人、1642 人和 3447 人。肺炎霉菌在第一期和第三期中占多数(分别为 23.4% 和 35.5%)。在第二阶段,呼吸道合胞病毒(RSV)成为主要病原体(20.3%),而甲型流感病毒(Flu A)和肺炎霉菌的检出率较低(分别为 1.8% 和 9.6%)。在第三阶段,甲型流感(15.8%)和肺炎嗜血杆菌的疫情均有所回升,而 RSV 的检出率则恢复到第一阶段的水平,肺炎链球菌和流感嗜血杆菌的检出率与第一阶段相比明显下降。年龄分层分析和月度变化证实了上述结论。在第二和第三阶段,多种病原体的季节性模式被打乱:结论:COVID-19 NPIs 对儿童 CAP 病原体流行有明显影响,NPIs 后观察到肺炎双球菌和甲型流感流行率上升。持续的病原体监测对于有效预防和控制儿童 CAP 至关重要。
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来源期刊
CiteScore
7.20
自引率
4.50%
发文量
120
审稿时长
6-12 weeks
期刊介绍: Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.
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