The Influence of the COVID-19 Pandemic on Pseudomonas aeruginosa Infection in Children, Henan, China

Dear Editor,

Nailya et al. published their findings in Indian Journal of Microbiology, reporting the epidemiological changes of respiratory pathogens in Kazakhstan under the influence of the coronavirus disease 2019 (COVID-19) pandemic [1]. In this study, we explored the impact of the COVID-19 pandemic on infection with Pseudomonas aeruginosa (P. aeruginosa), one of the main respiratory pathogens in children.

P. aeruginosa is a Gram-negative, rod-shaped, opportunistic human pathogen [2, 3]. The first infection with P. aeruginosa usually occurs in childhood under the age of 1 year [4]. Chronic infection with P. aeruginosa has been reported to be associated with high morbidity of cystic fibrosis (CF) and even responsible for 95% of deaths [5]. The World Health Organization (WHO) 2017 Priority List of Bacterial Pathogens shows that infections caused by Pseudomonas aeruginosa are a growing global health care concern, and also occupy an important position in the pathogens causing pneumonia in children in recent years [6]. Therefore, epidemiological changes in P. aeruginosa infection need to be monitored.

We compared the total number of P. aeruginosa positive cases in children (0–18 years) before and after the COVID-19 pandemic, as well as the number of positive cases of respiratory system and non-respiratory system in Henan Children’s Hospital. A total of 1770 samples (n = 243 in 2016, n = 196 in 2017, n = 263 in 2018, n = 275 in 2019, n = 260 in 2020, n = 266 in 2021, n = 267 in 2022) were included, of which 63.8% were obtained from the respiratory tract. During the three COVID-19 outbreaks in Henan, the number of positive respiratory P. aeruginosa dropped sharply, while the number of positive non-respiratory P. aeruginosa did not decline (Fig. 1a). The fact that the respiratory tract is the most frequently involved system in P. aeruginosa infections was supported by the data from this study (Fig. 1b), which also revealed that under 1 year (60%) was the predominant age of children with P. aeruginosa infection in respiratory system (Fig. 1c). Hence, P. aeruginosa infections occur mainly in the respiratory system of children under 1 year of age.

Fig. 1.

a The general trend of P. aeruginosa infection from 2016 to 2022. b Systemic distribution of P. aeruginosa positive cases. c The number of respiratory positive and non-respiratory positive in age groups

In addition, the number of respiratory and non-respiratory positive cases were analyzed among children of all ages (Fig. 2). The respiratory positive of P. aeruginosa among children younger than 1 year showed obvious downward during the twice COVID-19 pandemic in Henan, while the changes in non-respiratory system were completely opposite (Fig. 2a). In children aged 2–5 years, respiratory P. aeruginosa infections decreased only during the second pandemic (Fig. 2c). However, the respiratory P. aeruginosa infections increased slightly in children aged 1–2 years and 5–18 years (Fig. 2b, d). Therefore, epidemiological trend of the infection of P. aeruginosa in children had indeed changed before and after the COVID-19 pandemic in Henan.

Fig. 2.

The number of respiratory and non-respiratory positive of P. aeruginosa at the age of < 1y (a), 1y—2y (b), 2y—5y (c), and 5y—18y (d) in 2016—2022

In conclusion, the COVID-19 pandemic had a certain impact on the transmission of P. aeruginosa in children. Close monitoring of epidemiology changes should be accompanied by increased protection against respiratory P. aeruginosa infections in children, especially those under 1 year of age.

Declarations

Conflicts of interest

We declare no conflicts of interest.