Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct:111:196-203.
doi: 10.1016/j.ijid.2021.08.060. Epub 2021 Aug 26.

The drop in reported invasive pneumococcal disease among adults during the first COVID-19 wave in the Netherlands explained

Kirsten K T Dirkx  1 , Bert Mulder  2 , Annelies S Post  2 , Martijn H Rutten  3 , Caroline M A Swanink  4 , Heiman F L Wertheim  5 , Amelieke J H Cremers  5
Affiliations

The drop in reported invasive pneumococcal disease among adults during the first COVID-19 wave in the Netherlands explained

Kirsten K T Dirkx et al. Int J Infect Dis. 2021 Oct.

Abstract

Objectives: Streptococcus pneumoniae is the leading bacterial pathogen causing respiratory infections. Since the COVID-19 pandemic emerged, less invasive pneumococcal disease (IPD) was identified by surveillance systems worldwide. Measures to prevent transmission of SARS-CoV-2 also reduce transmission of pneumococci, but this would gradually lead to lower disease rates.

Design: Here, we explore additional factors contributing to the instant drop in pneumococcal disease cases captured in surveillance.

Results: Our observations on referral practices and other impediments to diagnostic testing indicate that residual IPD has likely occurred but remained undetected by conventional hospital-based surveillance.

Conclusions: Depending on the setting, we discuss alternative monitoring strategies that could improve understanding of pneumococcal disease dynamics.

Keywords: COVID-19; IPD; Pandemic; S. pneumoniae; Surveillance.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Annual bacteremic adult IPD cases hospitalized at the 3 study centers together. Cases are grouped by their identification date in 3-month time periods: December to February or March to May. Displayed are number of cases (panel A) and 30‑day mortality (panel B).
Figure 2
Figure 2
Timeline of governmental measures issued (upper graph) and bacteremic adult IPD cases hospitalized (lower graph) during the first COVID-19 wave in 2020 in the Netherlands.
Figure 3
Figure 3
Decreases in the prescription of amoxicillin by GPs in the study area during the first COVID-19 wave, stratified by patient age.
Figure 4
Figure 4
Patient characteristics of adult IPD cases captured during the first wave of COVID-19 (in red) compared to that period in the five years preceding (pink) and to the season preceding (blue). Time to presentation at the hospital is displayed in panel A, baseline health is represented in panels B (age) and C (Charlson comorbidity index score). Severity of pneumonia cases at the emergency department is shown in panels D (pneumonia severity index) and E (CURB-65). Ns = not significant.
See this image and copyright information in PMC

References

    1. Adler H, German EL, Mitsi E, Nikolaou E, Pojar S, Hales C. Experimental Human Pneumococcal Colonisation in Older Adults is Feasible and Safe, Not Immunogenic. Am J Respir Crit Care Med. 2020 - PMC - PubMed
    1. Azzari C, Cortimiglia M, Moriondo M, Canessa C, Lippi F, Ghori F. Pneumococcal DNA is not detectable in the blood of healthy carrier children by real-time PCR targeting the lytA gene. J Med Microbiol. 2011;60(Pt 6):710–714. - PMC - PubMed
    1. Barten DG, Latten GHP, van Osch FHM. Reduced Emergency Department Utilization During the Early Phase of the COVID-19 Pandemic: Viral Fear or Lockdown Effect? Disaster Med Public Health Prep. 2020:1–4. - PMC - PubMed
    1. Bogaert D, De Groot R, Hermans PW. Streptococcus pneumoniae colonisation: the key to pneumococcal disease. Lancet Infect Dis. 2004;4(3):144–154. - PubMed
    1. Brueggemann AB, Jansen van Rensburg MJ, Shaw D, McCarthy ND, Jolley KA, Maiden MCJ. Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data. Lancet Digit Health. 2021;3(6):e360–ee70. - PMC - PubMed

Substances