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In this journal, we read with great interest the findings published by Li et al. and Zhou et al., which report a decline in Streptococcus pneumoniae and Haemophilus influenzae infections in children in response to the COVID-19 pandemic.
In addition, Li et al. also found that COVID-19 had a greater impact on Escherichia coli isolated from children with respiratory tract infection than on children with digestive system infection.
However, there are no data on changes in Staphylococcus aureus (S. aureus) infection in respiratory system and in non-respiratory system in children before and after the COVID-19 pandemic.
S. aureus is a gram-positive, non-motor, coagulase positive globular bacterium that has a nasal carrying rate of about 30% in the population.
In particular, the emergence of community-acquired pneumonia (CAP) caused by methicillin-resistant S. aureus, which is the cause of severe pneumonia that leads to critical illness and death.
In addition, nosocomial pneumonia caused by S. aureus often complicates hospitalization and can lead to serious consequences, especially when acquired in the intensive care unit.
Bacterial vaccines have significantly reduced morbidity and mortality caused by several common pathogens, including Haemophilus influenzae type B, Streptococcus pneumoniae, Neisseria meningitisa, Diphtheria, Pertussis and Tetanus, however no vaccine has been developed to prevent S. aureus infections.
After the outbreak of COVID-19, a series of countermeasures are mainly to block the route of respiratory transmission. Here we introduce the overall incidence of S. aureus and the incidence of respiratory system and non-respiratory system infection in children during the COVID-19 pandemic in Henan, China.
To assess the impact of the COVID-19 epidemic on the epidemiological characteristics of children with S. aureus infection, laboratory data of children's bacterial culture records from Henan Children's Hospital (National Children's Regional Medical Center, Henan Children's Medical Center, and Henan Pediatric Disease Clinical Medical Research Center) from January 1, 2016 to October 31, 2022 were analyzed. The total number of S. aureus culture cases, respiratory positivity and non-respiratory positivity were analyzed each month (Fig. 1). A total of 4838 children were included (n = 742 in 2016, n = 783 in 2017, n = 719 in 2018, n = 805 in 2019, n = 650 in 2020, n = 690 in 2021, n = 449 in 2022). In the two COVID-19 outbreaks in Henan, the positive number of S. aureus in respiratory system decreased significantly. However, in the two COVID-19 outbreaks in Henan, the positive number of the positive number of S. aureus in non-respiratory system have no obvious changes. Despite a slight increase in the number of respiratory S. aureus positives in children recovering from the two COVID-19 pandemics, they are still lower than the same period before the pandemic. These results suggest that the COVID-19 pandemic has a significant impact on the epidemiological characteristics of S. aureus infections in respiratory system in children. While, the COVID-19 pandemic have no obvious influence on the epidemiological characteristics of S. aureus infections in non-respiratory system in children.
Fig. 1General trend of S. aureus infection from January 1, 2016 to October 31, 2022.
The number of S. aureus respiratory positives under 1 year of age accounted for 94% of the total S. aureus respiratory positives from 2016 to 2021 (Fig. 2A). While, non-respiratory positive S. aureus under 5 years of age accounted for 80% of the total number of non-respiratory positive S. aureus, especially under 3 years of age accounted for 71% of the total number of non-respiratory positive S. aureus between 2016 and 2021 (Fig. 2B). This also indicates that the population with S. aureus respiratory system infection is mainly under 1 year old, and the population with S. aureus non-respiratory system infection is mainly under 5 years old, especially under 3 years old.
Fig. 2(A) Cases of S. aureus positive infection in respiratory system from 2016 to 2021. (B) Cases of non-respiratory S. aureus positive infection in 2016-2021.
In conclusion, the COVID-19 pandemic has changed the prevalence of respiratory S. aureus infections in children in Henan. While, the COVID-19 pandemic almost have no obvious changes the prevalence of non-respiratory S. aureus infections in children in Henan. Since the outbreak of COVID-19, countries around the world have implemented a series of strong control measures, increased awareness of personal protection, and effectively stopped the spread of the virus. Currently, COVID-19 continues to break out in some areas. With the normalization of epidemic prevention and control, it continues to affect people's living, traveling, learning, working and other ways, as well as the microbial community, especially the epidemiology of pathogens. Therefore, the long-term prevalence of S. aureus in children's deserves our continued attention. In addition, special attention should be paid to the risk of respiratory S. aureus infection in children under 1 year of age, and effective preventive measures should be taken promptly.
In summary, during the COVID-19 pandemic, there was a downward trend in children with respiratory S. aureus infections, apparently. While, the COVID-19 pandemic have no obvious changes non-respiratory S. aureus infections. Close monitoring of epidemiological trends can help prevent outbreaks of respiratory S. aureus infections in children, especially those under 1 year of age.
Declaration of Competing Interest
The authors declare no conflict of interests.
Acknowledgements
This work was funded by the National Natural Science Foundation of China (32201237), China Postdoctoral Science Foundation (2020M672301), Scientific and technological projects of Henan province (222102310270, 222102310109)
References
Li Y.
Guo Y.
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Changes in Streptococcus pneumoniae infection in children before and after the COVID-19 pandemic in Zhengzhou, China.
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