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Twenty-Five Year Trend Change in the Etiology of Pediatric Invasive Bacterial Infections in Korea, 1996-2020
Seung Ha Song1, Hyunju Lee2,3, Hoan Jong Lee1,3
1Department of Pediatrics, Seoul National University Hospital, Seoul, Korea.
Insights
Pediatric invasive bacterial infections (IBIs) showed a decreasing trend for Streptococcus pneumoniae and Haemophilus influenzae, with an increasing trend for Staphylococcus aureus, Streptococcus agalactiae, and Streptococcus pyogenes pre-pandemic. This data provides a baseline for post-COVID-19 era IBI epidemiology. Keywords: pediatric invasive bacterial infection, IBI, Streptococcus pneumoniae, Staphylococcus aureus.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Microbiology
Background:
- The COVID-19 pandemic has altered infectious disease patterns.
- Understanding pre-pandemic pediatric invasive bacterial infection (IBI) epidemiology is crucial.
Purpose of the Study:
- To establish the pre-pandemic epidemiological trends of pediatric IBIs in Korea.
- To analyze changes in the proportion of specific bacterial pathogens causing IBIs over time.
Main Methods:
- Retrospective multicenter surveillance of pediatric IBIs from 1996-2020 in Korea.
- Inclusion of immunocompetent children over 3 months of age with IBIs caused by eight key bacteria.
- Analysis of annual trends in the relative proportions of causative pathogens.
Main Results:
- Over 2,195 IBI episodes were recorded between 1996-2020.
- Streptococcus pneumoniae was most common in younger children (3-59 months), while Staphylococcus aureus predominated in older children (≥5 years).
- A significant decreasing trend was observed for S. pneumoniae and Haemophilus influenzae, contrasted by increasing trends for S. aureus, S. agalactiae, and S. pyogenes (excluding 2020 data).
Conclusions:
- Pre-pandemic pediatric IBI epidemiology showed a decline in S. pneumoniae and H. influenzae.
- An rise in S. aureus, S. agalactiae, and S. pyogenes proportions was noted.
- These findings serve as essential baseline data for monitoring pediatric IBI trends in the post-COVID-19 era.
Background:
The coronavirus disease-2019 (COVID-19) pandemic has contributed to the change in the epidemiology of many infectious diseases. This study aimed to establish the pre-pandemic epidemiology of pediatric invasive bacterial infection (IBI).
Methods:
A retrospective multicenter-based surveillance for pediatric IBIs has been maintained from 1996 to 2020 in Korea. IBIs caused by eight bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Listeria monocytogenes, and Salmonella species) in immunocompetent children > 3 months of age were collected at 29 centers. The annual trend in the proportion of IBIs by each pathogen was analyzed.
Results:
A total of 2,195 episodes were identified during the 25-year period between 1996 and 2020. S. pneumoniae (42.4%), S. aureus (22.1%), and Salmonella species (21.0%) were common in children 3 to 59 months of age. In children ≥ 5 years of age, S. aureus (58.1%), followed by Salmonella species (14.8%) and S. pneumoniae (12.2%) were common. Excluding the year 2020, there was a trend toward a decrease in the relative proportions of S. pneumoniae (rs = -0.430, P = 0.036), H. influenzae (rs = -0.922, P < 0.001), while trend toward an increase in the relative proportion of S. aureus (rs = 0.850, P < 0.001), S. agalactiae (rs = 0.615, P = 0.001), and S. pyogenes (rs = 0.554, P = 0.005).
Conclusion:
In the proportion of IBIs over a 24-year period between 1996 and 2019, we observed a decreasing trend for S. pneumoniae and H. influenzae and an increasing trend for S. aureus, S. agalactiae, and S. pyogenes in children > 3 months of age. These findings can be used as the baseline data to navigate the trend in the epidemiology of pediatric IBI in the post COVID-19 era.
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