Surge in Mycoplasma Pneumoniae infection and Respiratory Viruses Co-infection in Children With Community-Acquired Pneumonia in the Post-Pandemic.

IF 1.7 Q2 PEDIATRICS Pediatric health, medicine and therapeutics Pub Date : 2024-09-07 eCollection Date: 2024-01-01 DOI:10.2147/PHMT.S473669
Jie Chi, Heng Tang, Fang Wang, Yuxuan Wang, Zhifeng Chen
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Abstract

Purpose: During the COVID-19 pandemic, multifaceted non-pharmaceutical interventions have not only reduced the transmission of SARS-CoV2 but also affected the prevalence of other respiratory pathogens. With the lifting of many restrictions, a surge in cases of pneumonia in children has been reported in many hospitals in China. The study assessed the changes in pathogen and symptoms of children with community-acquired pneumonia (CAP) before and after the adjustments of prevention and control measures of epidemic and provided recommendations for CAP in children.

Patients and methods: Children diagnosed with CAP were enrolled in the study from 2022 to 2023. A cross-sectional retrospective study was conducted in a general hospital. We analyzed the data about demographic data, clinical symptoms, pathogens, and medical treatments. The Chi-square and Mann-Whitney U-test were used to assess the statistical significance of groups.

Results: We studied 1103 children, 339 in 2022 and 764 in 2023. Compared with children in 2022, more children were diagnosed with CAP in 2023 and these children had a higher body temperature and levels of CRP and PCT, which indicated these children got severe inflammation. The positive rate of the pathogen was also higher in 2023, especially the detective rate of Mycoplasma pneumoniae. The number of children infected with more than two pathogens was higher in 2023, especially those co-infected with the virus and M. Pneumoniae. Concerning the medicine therapy, the usage of β-lactam antibiotics, Macrolide antibiotics, and antiviral drugs kept rapid growth.

Conclusion: After the adjustment of epidemic prevention and control policies in 2023, more children got CAP with severe clinical symptoms, and more antibiotics and antiviral drugs were used. Further study is needed to explore the reasons for the increase in children with CAP and to explore the rationality of treatment.

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大流行后社区获得性肺炎患儿肺炎支原体感染和呼吸道病毒合并感染率激增。
目的:在 COVID-19 大流行期间,多方面的非药物干预措施不仅减少了 SARS-CoV2 的传播,还影响了其他呼吸道病原体的流行。随着许多限制措施的取消,中国许多医院报告的儿童肺炎病例激增。该研究评估了疫情防控措施调整前后社区获得性肺炎(CAP)患儿病原体和症状的变化,并为儿童 CAP 提供建议:研究对象为2022年至2023年确诊为CAP的儿童。我们在一家综合医院开展了一项横断面回顾性研究。我们分析了人口统计学数据、临床症状、病原体和治疗方法。采用卡方检验(Chi-square)和曼-惠特尼U检验(Mann-Whitney U-test)评估各组间的统计学意义:我们对1103名儿童进行了研究,其中2022年339名,2023年764名。与2022年的儿童相比,2023年有更多的儿童被诊断为CAP,这些儿童的体温、CRP和PCT水平更高,这表明这些儿童患有严重的炎症。2023 年的病原体阳性率也更高,尤其是肺炎支原体的检测率。2023 年感染两种以上病原体的儿童人数较多,尤其是同时感染病毒和肺炎支原体的儿童。在药物治疗方面,β-内酰胺类抗生素、大环内酯类抗生素、抗病毒药物的使用量保持快速增长:结论:2023 年疫情防控政策调整后,临床症状严重的 CAP 患儿增多,抗生素和抗病毒药物的使用量增加。需要进一步研究CAP患儿增加的原因,探讨治疗的合理性。
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