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Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, ChinaDepartment of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
reported the changes in Streptococcus pneumoniae and Haemophilus influenzae infections in children before and after the Coronavirus disease 2019 (COVID-19) pandemic, which attracted our intense attention and interest. However, no data is available regarding pathogen distribution of bacterial meningitis. Here, we present the pathogen distribution of children with bacterial meningitis before and after the COVID-19 pandemic in Zhengzhou, China.
Bacterial meningitis is a common infectious disease of the central nervous system in children. In China, the incidences varies between 20 and 80 cases per 100 000 population
Short-term and long-term risk of mortality and neurodevelopmental impairments after bacterial meningitis during infancy in children in Denmark and the Netherlands: a nationwide matched cohort study.
Mortality, neurodevelopmental impairments, and economic outcomes after invasive group B streptococcal disease in early infancy in Denmark and the Netherlands: a national matched cohort study.
. Bacterial meningitis could be caused by pathogen infection acquired through birth contact, inhalation, nasopharyngeal colonization and blood flow invasion
changing epidemiology of bacterial meningitis since introduction of conjugate vaccines: 3 decades of national meningitis surveillance in the Netherlands.
. The distribution of pathogens may be different in different regions. Since the outbreak of COVID-19 pandemic in 2019, many countries have implemented strict intervention measures, such as wearing masks, keeping hands clean and keeping social distance, limiting outdoor activities, etc. COVID-19 and related measures have seriously affected people's lifestyle, and may also affect the epidemiology of pathogens. Hence, we assessed the number of children's bacterial meningitis cases and the distribution of pathogens before and after the COVID-19 pandemic, providing a basis for hospital infection prevention and clinical management strategies.
In this study, we compared the number of child cases with bacterial meningitis and the proportion of different pathogens before and after the COVID-19 pandemic in Zhengzhou Children's Hospital to explore the impact of the COVID-19 pandemic on the pathogen distribution of bacterial meningitis in children. The results showed that (Fig. 1) the number of bacterial meningitis in children declined significantly in 2020 (n = 622 in 2018, n = 372 in 2019, n = 138 in 2020 and n = 213 in 2021). However, the number decline could be restriction of movement to the city from town or village. The total positive numbers with reported pathogen were 375 (n = 142 in 2018, n = 93 in 2019, n = 71 in 2020 and n = 69 in 2021). The number of positive cerebrospinal fluid cultures decreased in 2020, the first year of COVID-19 pandemic. However, the total positive rates were not following the decreasing trend.
Fig. 1The number of cerebrospinal fluid (CSF) culture samples, positive CSF culture from 2018 to 2021.
In addition, we analyzed the distribution of pathogens in cerebrospinal fluid cultures of children with bacterial meningitis before and after the COVID-19 pandemic (Table 1, Fig. 2). The results showed that before and after the COVID-19 pandemic, the pathogenic bacteria in cerebrospinal fluid culture of children with bacterial meningitis were mainly coagulase negative staphylococcus, Enterococcus faecium, Streptococcus pneumoniae, E. coli, Klebsiella pneumoniae, and Staphylococcus aureus, accounting for more than 65% of the pathogenic microorganisms. Among these pathogens, the percentage of Enterococcus faecium and Streptococcus pneumoniae decreased from 2018 to 2020, and then increased slightly in 2021. The percentage of Acinetobacter baumannii gradually decreased in 2020. However, the percentage of E. coli gradually increased in 2020. In addition, Haemophilus influenzae and Stenotrophomonas maltophilia were detected in 2018 and 2019, but were not detected in 2020 and 2021. Other pathogens kept a relatively stable state.
Table 1The pathogen distribution of cerebrospinal fluid cultures in children.
Our data indicated that the COVID-19 pandemic reduced the number of cases of bacterial meningitis in children and changed the distribution of pathogens in cerebrospinal fluid cultures. With the COVID-19 pandemic under control gradually, people's life return to normal, and the distribution of pathogens also changes. For example, the proportion of Enterococcus faecium and Streptococcus pneumoniae decreased during the period of strict control of COVID-19 (2020), while S. maltophilia and H. influenzae were not detected. Therefore, it is necessary to pay attention to the changes of pathogen distribution in children's bacterial meningitis before and after the COVID-19 pandemic.
In conclusion, since the outbreak of COVID-19, the number of children with bacterial meningitis has decreased significantly, and the distribution of pathogens has also changed. Effective and continuous monitoring is of great significance for the prevention and control of bacterial meningitis in children.
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgment
This work was supported by grant from the Medical Science and Technology of Henan Province (2018020656)
References
Li Y.
Guo Y.
Duan Y
Changes in Streptococcus pneumoniae infection in children before and after the COVID-19 pandemic in Zhengzhou.
Short-term and long-term risk of mortality and neurodevelopmental impairments after bacterial meningitis during infancy in children in Denmark and the Netherlands: a nationwide matched cohort study.
Mortality, neurodevelopmental impairments, and economic outcomes after invasive group B streptococcal disease in early infancy in Denmark and the Netherlands: a national matched cohort study.
changing epidemiology of bacterial meningitis since introduction of conjugate vaccines: 3 decades of national meningitis surveillance in the Netherlands.
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