Impact of COVID-19 on the Prevalence and Drug Resistance of Bacteria Isolated From Bacterial Meningitis Cerebrospinal Fluid in Shandong Province: A Multicenter Retrospective Study

J Med Virol. 2024 Nov;96(11):e70063. doi: 10.1002/jmv.70063.

Abstract

Our objective was to evaluate the ramifications of the 2019 coronavirus disease (COVID-19) pandemic on the microbial profile and antimicrobial resistance patterns of bacteria isolated from cerebrospinal fluid (CSF) specimens of patients with bacterial meningitis. We conducted a retrospective analysis of laboratory results and clinical records about positive CSF cultures reported by the SPARSS network from 2017 to 2023. The study covered three distinct periods: January 2017 to December 2019 (before the COVID-19 pandemic), January 2020 to December 2022 (during the COVID-19 pandemic), and January 2023 to December 2023 (after the COVID-19 pandemic), with a total of 5793 CSF isolates collected. Notably, the proportion of male patients (61.3%) was higher than that of females. After COVID-19, we observed a notable shift in the seasonal peak of CSF pathogens, with a delay of approximately 3 months. Remarkable alterations were evident in both pediatric and adult CSF isolate profiles. In children, the predominant pathogens included coagulase-negative Staphylococcus (CoNS), Streptococcus pneumonia, and Escherichia coli. Notably. After COVID-19, there was a significant decrease in the proportion of CoNS (p = 0.0039) and a notable increase in E. coli (p = 0.0067). In adults, the top three pathogens were CoNS, Acinetobacter baumannii, and Klebsiella pneumoniae. After the pandemic, we observed a significant reduction in the prevalence of A. baumannii (p = 0.0059), while the proportions of K. pneumoniae, Pseudomonas aeruginosa, Enterobacter cloacae, and Enterococcus faecalis increased significantly (p < 0.05). Additionally, among multidrug-resistant bacteria, the detection rate of carbapenem-resistant E. coli escalated (p = 0.0375). Antimicrobial susceptibility analysis indicated a declining trend in resistance rates for CoNS and A. baumannii to certain antibiotics following the pandemic. Conversely, resistance to imipenem in A. baumannii increased. In conclusion, the COVID-19 pandemic has significantly influenced the composition, antimicrobial resistance patterns, and epidemiological dynamics of CSF-isolated bacteria in Shandong province. To effectively address these changes, ongoing and dynamic surveillance of pathogen trends and antimicrobial resistance rate is essential.

Keywords: COVID‐19; China; adult; cerebrospinal fluid; children; resistance rate.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Bacteria* / classification
  • Bacteria* / drug effects
  • Bacteria* / isolation & purification
  • COVID-19* / cerebrospinal fluid
  • COVID-19* / epidemiology
  • COVID-19* / microbiology
  • Cerebrospinal Fluid / microbiology
  • Cerebrospinal Fluid / virology
  • Child
  • Child, Preschool
  • China / epidemiology
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Infant
  • Male
  • Meningitis, Bacterial* / cerebrospinal fluid
  • Meningitis, Bacterial* / epidemiology
  • Meningitis, Bacterial* / microbiology
  • Microbial Sensitivity Tests
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification
  • Young Adult

Substances

  • Anti-Bacterial Agents