SARS-CoV-2和肺炎菌菌的殖民和疾病:成年人的观察性研究
Sara Calvo-Silveria1,2, Lucía Fernández-Delgado1,2, Aida González-Díaz1,2
1Department of Microbiology, Hospital Universitari de Bellvitge - IDIBELL-UB, Barcelona, Spain.
Frontiers in cellular and infection microbiology
|August 4, 2025
概括
在COVID-19期间的非药物干预减少了侵入性肺炎球菌病,但没有消除共感染. 与SARS-CoV-2共同感染的肺炎链球菌可能会增加疾病的严重程度,这强调了继续接种疫苗的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 微生物学 微生物学
背景情况:
- 在全球范围内,COVID-19大流行严重影响了呼吸道病原体的动态.
- 虽然SARS-CoV-2疫苗可以减少疾病的严重程度,但新兴变种的挑战仍然存在.
- 需要澄清的是,SARS-CoV-2和与严重呼吸系统疾病的常见原因 - - 肺炎链球菌 (Streptococcus pneumoniae) 的联合感染之间的关系.
研究的目的:
- 分析SARS-CoV-2和Streptococcus pneumoniae的同时发生情况.
- 研究对疾病进展,殖民率和临床结果的影响.
- 评估流行病期间侵入性肺炎球菌病 (IPD) 发病率和肺炎球菌血清型分布的变化.
主要方法:
- 对入侵性肺炎球菌病例 (2019-2023) 的实验室分析.
- 对肺炎球菌分离物 (2020-2023) 的住院COVID-19患者的回顾性分析,包括临床和微生物学数据.
- 在SARS-CoV-2阳性鼻样本 (2023) 中肺炎球菌殖民的回顾性评估,使用双目标RT-PCR.
- 全基因组测序 (WGS) 用于细菌和病毒基因组分析,包括血型定型,耐药性分析和血统确定.
- 使用奇平方和费舍尔测试进行统计比较.
主要成果:
- 在COVID-19大流行期间 (2019-2021),IPD发病率下降了70%,在2021年后随着非药物措施的放宽而反弹.
- 肺炎球菌血清型分布保持稳定,血清型12F重新出现,成为一种多药耐药系.
- 在66名住院患者中发生了SARS-CoV-2和肺炎球菌联合感染,主要是3型血清,对宏类和四环素有耐药性.
- 在SARS-CoV-2患者中肺炎球菌的殖民性很低 (2.8%),在严重病例和年轻成年人中比率更高.
- 与殖民患者相比,同时感染的患者表现出更多的并发病,严重的临床表现,更高的住院率和更低的疫苗接种率.
结论:
- 非药品措施显著破坏了Streptococcus pneumoniae的动态.
- 虽然SARS-CoV-2患者的肺炎球菌殖民是罕见的,但同时感染与疾病严重程度的增加有关.
- 疫苗接种计划和持续监测对于预防严重的呼吸道感染至关重要.
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