Reduction in the incidence of invasive infections caused by encapsulated bacteria after the onset of the COVID-19 pandemic

Rev Argent Microbiol. 2024 Jan-Mar;56(1):62-68. doi: 10.1016/j.ram.2023.06.003. Epub 2023 Jul 5.

Abstract

Interaction between severe acute respiratory coronavirus 2 (SARS-CoV-2) and IIEB remains under investigation. Objective: to compare IIEB incidence before and during COVID-19 pandemic, and assess incidence of coinfection with COVID-19 and case fatality. A cross-sectional study was performed on data from a centralized microbiology laboratory serving a network of healthcare centers comprising 713 pediatric and adult inpatient beds, expanded by 20% during the pandemic. Three periods were evaluated: (1) pre-pandemic: March 1, 2019-February 29, 2020; (2) pandemic year 1: March 1, 2020-February 28, 2021; (3) pandemic year 2: March 1, 2021-July 31, 2021. Descriptive statistical analysis was performed. 56 502 samples (96% blood cultures) from 27224 patients were analyzed. Of these, 54 samples (from 54 patients) were positive for encapsulated bacteria. IIEB incidence was: 167.4, 32.6, and 50.4 per 100000 samples for periods 1, 2, and 3, respectively. Twelve IIEB episodes occurred during the pandemic period: 10 Streptococcus pneumoniae, and 2 Haemophilus influenzae, of which 7 were SARS-CoV-2/S. pneumoniae coinfections, with an incidence of 5.68 per 10000 COVID-19-related hospitalizations (0.056%). IIEB case fatality was 31%, 29%, and 60% for each period, respectively, 3/7 patients with coinfection died (43%). Case fatality for invasive pneumococcal disease (IPD) in patients without COVID-19, was 32.5%. Significant reduction in IIEB incidence was observed during the pandemic, coinciding with implementation of containment measures. The incidence of SARS-CoV-2/S. pneumoniae coinfection was low, with higher case fatality than IPD patients without COVID-19.

Keywords: COVID-19; Case fatality; Coinfección SARS-CoV-2/S. pneumoniae coinfección; Encapsulated bacteria; Enfermedad neumocócica invasiva; Incidence; Incidencia; Invasive pneumococcal disease; Letalidad; Microorganismos capsulados; S. pneumoniae; SARS-CoV-2/S. pneumoniae coinfection.

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • Child
  • Coinfection* / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Incidence
  • Pandemics
  • Pneumococcal Infections*
  • SARS-CoV-2
  • Streptococcus pneumoniae