Epidemiology of Invasive Streptococcal Infections Before and During the COVID-19 Pandemic in Nakhon Phanom Province: S.agalactiae and S.pneumoniae infection.
Keywords:
Invasive Streptocococci, S.agalatiae, S. pneumoniae, COVID-19, Risk factorsAbstract
This retrospective study aimed to investigate and compare the epidemiological characteristics of invasive Streptococci infections caused by Streptococcus agalactiae and Streptococcus pneumoniae among hospitalized patients in Nakhon Phanom Province during the pre–COVID-19 period (2010–2019) and the COVID-19 period (2020–2023). Additionally, the study aimed to identify factors associated with both infections. Data were analyzed using descriptive statistics, Chi-square test, and multivariable logistic regression, with a significance level set at 0.05.
The results showed that the overall prevalence of S. agalactiae infection was 3.19 per 100,000 population, decreasing from 3.43 per 100,000 in the pre-pandemic period to 2.60 per 100,000 during the pandemic. Similarly, the prevalence of S. pneumoniae infection was 1.81 per 100,000 population, declining from 2.31 per 100,000 before the pandemic to 1.03 per 100,000 during the COVID-19 period.
Comparative analysis revealed that both S. agalactiae and S. pneumoniae infections were significantly associated with abnormal basophil counts and intensive care unit (ICU) admission (S. agalactiae: p < 0.001 and p = 0.005; S. pneumoniae: p = 0.008 and p < 0.001, respectively).
Multivariable logistic regression analysis identified factors associated with S. agalactiae infection, including age 0–9 years (adjusted OR = 0.40, 95% CI: 0.18–0.97, p = 0.043), abnormal hematocrit levels (≤36.9% or ≥60%) (adjusted OR = 0.38, 95% CI: 0.41–0.80, p = 0.001), abnormal white blood cell counts (≤4,400 or ≥11,301 cells/µL) (adjusted OR = 1.61, 95% CI: 1.11–2.33, p = 0.010), detection of the pathogen in cerebrospinal fluid (adjusted OR = 0.38, 95% CI: 0.21–0.83, p = 0.014), and detection in synovial fluid (adjusted OR = 5.97, 95% CI: 1.18–30.15, p = 0.031).
For S. pneumoniae infection, significant associated factors included age 0–9 years (adjusted OR = 4.40, 95% CI: 2.32–8.08, p < 0.001) and ICU admission (adjusted OR = 1.77, 95% CI: 1.04–2.87, p = 0.034).
In conclusion, although the prevalence of both S. agalactiae and S. pneumoniae infections decreased during the COVID-19 pandemic, the severity of infections appeared to increase.
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