Assessing the influence of the COVID-19 pandemic on the incidence, clinical presentation, and clindamycin resistance rates of Streptococcus pyogenes infections

Marco, Daniel N.; Canela, José; Brey, Maria; Soriano, Alex; Pitart, Cristina; Herrera, Sabina

doi:10.1016/j.ijregi.2024.03.004

IJID Regions

2024

DOI: 10.1016/j.ijregi.2024.03.004

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Assessing the influence of the COVID-19 pandemic on the incidence, clinical presentation, and clindamycin resistance rates of Streptococcus pyogenes infections

Daniel N. Marco,

José Canela,

Maria Brey

et al.

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2024

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Cited by 4 publications

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Implementation of molecular diagnostic testing for group a streptococcal pharyngitis: considerations and challenges with a focus on point-of-care environments

Sugden,

Loeffelholz

2024

Expert Review of Molecular Diagnostics

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Implementation of molecular diagnostic testing for group a streptococcal pharyngitis: considerations and challenges with a focus on point-of-care environments

Sugden,

Loeffelholz

2024

Expert Review of Molecular Diagnostics

View full text Add to dashboard Cite

Impact of the COVID-19 Pandemic on Group A Streptococcal Necrotizing Soft Tissue Infections: A Retrospective Cohort Study

Epprecht,

Weller,

Hofmaenner

et al. 2024

Open Forum Infectious Diseases

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Background Necrotizing soft-tissue infections (NSTIs) are often caused by Group A Streptococcus (GAS). As the number of invasive GAS infections decreased during the COVID-19 pandemic restrictions, this study aimed to compare the occurrence of GAS-NSTIs before, during, and after the COVID-19 pandemic restrictions. Methods This retrospective cohort study included adult patients with NSTIs admitted to the intensive care unit (ICU) of the University Hospital Zurich, Switzerland, from July 2008 to December 2023. NSTI cases were categorized as pre-, during-, and post-restrictions. The primary outcome was the proportion of GAS in NSTI, and the exploratory secondary outcome was in-hospital death. Data analysis was conducted using Firth logistic regression adjusted for age, sex, diabetes and initially affected body region. Results Overall, 74 NSTI cases were identified, with 49 occurring before, eight during, and 17 after the pandemic restrictions. GAS was isolated in 27 (36%) cases, with 17 (35%) pre- and 10 (59%) post-restrictions, but none during the restrictions. NSTIs caused by other bacteria persisted during the restrictions. The odds of GAS were significantly lower during the restrictions (adjusted odds ratio [aOR]: 0.02, 95% confidence interval [CI]: 0.001–0.81) compared to after, while no significant differences were found between pre- and post-restrictions periods. Conclusions The significant decrease of GAS-NSTIs during the COVID-19 pandemic restrictions suggests that isolation measures may have prevented the transmission of GAS resulting in a decline of GAS-NSTIs while NSTIs caused by bacteria transmitted by alternative routes persisted.

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Prevalence and Predictors of Concomitant Bacterial Infections in Patients With Respiratory Viruses in Ontario: A Cohort Study

Wang,

Swayze,

Brown

et al. 2024

Open Forum Infectious Diseases

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Background To investigate the prevalence of concomitant bacterial infection across common viral infections. Methods This population-based cohort study included patients infected with influenza A and B (FLUA, FLUB) and respiratory syncytial virus (RSV) in Ontario between 2017 and 2019 and patients with SARS-CoV-2 between 2020 and 2021. Specific bacteria present in concomitant infections were identified. Concomitant infections were further classified into different categories (eg, coinfection −2 to +2 days from viral infection and secondary infection >2 days after viral infection). We used logistic regression models to estimate the odds of bacterial infections for FLUA, FLUB, and RSV relative to SARS-CoV-2 while adjusting for confounders. Results A total of 4230 (0.5%, 885 004) viral cases had concomitant bacterial infections, encompassing 422 of FLUB (4.7%, 8891), 861 of FLUA (3.9%, 22 313), 428 of RSV (3.4%, 12 774), and 2519 of COVID-19 (0.3%, 841 026). The most prevalent species causing concomitant bacterial infection were Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa. When compared with SARS-CoV-2, the adjusted odds ratio for bacterial infection was 1.69 (95% CI, 1.48–1.93) for FLUA, 2.30 (95% CI, 1.97–2.69) for FLUB, and 1.56 (95% CI, 1.33–1.82) for RSV. The adjusted odds of coinfection in patients with SARS-CoV-2 were lower but higher for secondary infection as compared with the other viruses. Conclusions A higher prevalence and risk of concomitant bacterial infection were found in FLUA, FLUB, and RSV as compared with SARS-CoV-2, although this is largely driven by coinfections. Ongoing surveillance efforts are needed to compare the risk of concomitant infections during periods when these viruses are cocirculating.

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Assessing the influence of the COVID-19 pandemic on the incidence, clinical presentation, and clindamycin resistance rates of Streptococcus pyogenes infections

Cited by 4 publications

References 23 publications

Implementation of molecular diagnostic testing for group a streptococcal pharyngitis: considerations and challenges with a focus on point-of-care environments

Implementation of molecular diagnostic testing for group a streptococcal pharyngitis: considerations and challenges with a focus on point-of-care environments

Impact of the COVID-19 Pandemic on Group A Streptococcal Necrotizing Soft Tissue Infections: A Retrospective Cohort Study

Prevalence and Predictors of Concomitant Bacterial Infections in Patients With Respiratory Viruses in Ontario: A Cohort Study

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