The impact of the COVID-19 pandemic on pediatric bloodstream infections and alteration in antimicrobial resistance phenotypes in Gram-positive bacteria, 2020-2022.
Humans
COVID-19
/ epidemiology
Child
Retrospective Studies
Bacteremia
/ microbiology
Child, Preschool
Infant
Iran
/ epidemiology
Adolescent
Gram-Positive Bacterial Infections
/ epidemiology
Phenotype
Drug Resistance, Bacterial
Microbial Sensitivity Tests
Gram-Positive Bacteria
/ drug effects
Female
Male
Anti-Bacterial Agents
/ therapeutic use
Fungemia
/ epidemiology
Infant, Newborn
Bloodstream infections
COVID-19
Child, hospitalized
Gram-positive bacteria
Microbial Sensitivity Test
Yeasts
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
18 Oct 2024
18 Oct 2024
Historique:
received:
29
05
2024
accepted:
10
10
2024
medline:
19
10
2024
pubmed:
19
10
2024
entrez:
18
10
2024
Statut:
epublish
Résumé
Alteration in the etiology of pediatric bloodstream infections (BSIs) and antimicrobial resistance (AMR) is not well known during the Coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the impact of the COVID-19 pandemic on pediatric BSIs and alteration in antimicrobial resistance phenotypes in Gram-positive bacteria. The frequency of BSIs among children under 18 years old was retrospectively recorded in a tertiary children's hospital in Tehran, Iran from February 2020 to December 2022. The status of COVID-19 infection using reverse transcription polymerase chain reaction, bacteremia/fungemia according to BACTEC 9120 Culture System results, characterization of bacteria using biochemical tests, and antimicrobial susceptibility patterns for Gram-positive bacterial isolates using disk diffusion method were determined. Statistical analysis was done to measure the correlation of COVID-19 infection with BSIs and AMR. Out of 13,345 COVID-19 tests and 4,194 BACTEC blood culture requests, bacteremia/fungemia were confirmed in 10.37% (435/4,194) of the patients who requested both tests simultaneously. The COVID-19 infection was confirmed in 25.3% (110/435) of the patients with bacteremia/fungemia. The infection with characterized Gram-positive bacteria (GPB) and fungi was detected in 32.3% (140/433) and 8.31% (36/433) of the cases, respectively. Coagulase-negative Staphylococcus (CNS, 72, 16.62%), S. aureus (36, 8.3%), and Enterococcus spp. (22, 5%) were among the common isolates. Candida spp. and non-Candida yeasts were detected in 6.7% and 13.4% of the cases, respectively. A positive correlation was shown between the CNS bacteremia and COVID-19 infection (p-value = 0.019). Antibiotic susceptibility testing results showed the highest frequency of resistance to azithromycin among CNS, azithromycin and tetracycline among S. aureus and tetracycline among Enterococcus spp. Methicillin-resistance phenotype in the S. aureus (MRSA) and coagulase-negative Staphylococcus spp. (MR-CNS) was detected in 40% and 61.5% of the strains, respectively and the Enterococci were resistant to vancomycin in 33.3% of the isolates. A decline in the trend of BSIs by GPB and an increase in AMR was shown in children during the COVID-19 pandemic. Increasing antibiotic resistance is a concern; however, chloramphenicol, linezolid, and vancomycin remain active against common causes of GPB-BSIs.
Sections du résumé
BACKGROUND
BACKGROUND
Alteration in the etiology of pediatric bloodstream infections (BSIs) and antimicrobial resistance (AMR) is not well known during the Coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the impact of the COVID-19 pandemic on pediatric BSIs and alteration in antimicrobial resistance phenotypes in Gram-positive bacteria.
METHODS
METHODS
The frequency of BSIs among children under 18 years old was retrospectively recorded in a tertiary children's hospital in Tehran, Iran from February 2020 to December 2022. The status of COVID-19 infection using reverse transcription polymerase chain reaction, bacteremia/fungemia according to BACTEC 9120 Culture System results, characterization of bacteria using biochemical tests, and antimicrobial susceptibility patterns for Gram-positive bacterial isolates using disk diffusion method were determined. Statistical analysis was done to measure the correlation of COVID-19 infection with BSIs and AMR.
RESULTS
RESULTS
Out of 13,345 COVID-19 tests and 4,194 BACTEC blood culture requests, bacteremia/fungemia were confirmed in 10.37% (435/4,194) of the patients who requested both tests simultaneously. The COVID-19 infection was confirmed in 25.3% (110/435) of the patients with bacteremia/fungemia. The infection with characterized Gram-positive bacteria (GPB) and fungi was detected in 32.3% (140/433) and 8.31% (36/433) of the cases, respectively. Coagulase-negative Staphylococcus (CNS, 72, 16.62%), S. aureus (36, 8.3%), and Enterococcus spp. (22, 5%) were among the common isolates. Candida spp. and non-Candida yeasts were detected in 6.7% and 13.4% of the cases, respectively. A positive correlation was shown between the CNS bacteremia and COVID-19 infection (p-value = 0.019). Antibiotic susceptibility testing results showed the highest frequency of resistance to azithromycin among CNS, azithromycin and tetracycline among S. aureus and tetracycline among Enterococcus spp. Methicillin-resistance phenotype in the S. aureus (MRSA) and coagulase-negative Staphylococcus spp. (MR-CNS) was detected in 40% and 61.5% of the strains, respectively and the Enterococci were resistant to vancomycin in 33.3% of the isolates.
CONCLUSION
CONCLUSIONS
A decline in the trend of BSIs by GPB and an increase in AMR was shown in children during the COVID-19 pandemic. Increasing antibiotic resistance is a concern; however, chloramphenicol, linezolid, and vancomycin remain active against common causes of GPB-BSIs.
Identifiants
pubmed: 39425109
doi: 10.1186/s12887-024-05146-7
pii: 10.1186/s12887-024-05146-7
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
671Subventions
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Organisme : Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ID : IR.SBMU.MSP.REC.1401.060
Informations de copyright
© 2024. The Author(s).
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