I saw pertussis (whooping cough) data this week that reflects both antivaccine sentiment as well as the possibility of COVID damaged immune systems leading to spread. All of the data used in these graphs is from the UK.
I wanted to find data on diseases that weren’t vaccine preventable to look more closely at the immune damage component. I hit the jackpot with some data for organisms I’m very familiar within my particular field of healthcare infection prevention.
I was concerned though that many people may not be used to a data visualization like this, so I decided to take the raw data and place it into a form people would be more familiar with, but more importantly, adding pre-pandemic and mid-pandemic trend lines to compare to each other. I omitted the data from 2020 since there were so many other variables coming into play, particularly social distancing and much more focus on hand hygiene, which both would skew data for that year more than others. I also attempted to balance the dumber of quarters on each side of 2020 and used the most current data available.
This data is all bloodstream infections (except for C. difficile) with these organisms, ie, invasive disease, not just a topical infection on the skin.
Staphylococcus aureus
This organism is commonly found on the skin and is responsible for about 25% of serious surgical site infections.
MSSA is methicillin sensitive S. Aureus and is distinguished from an antibiotic-resistant strain known as methicillin resistant S. Aureus.
What is particularly interesting about these is that while the rate of MSSA in the population didn’t increase much, MRSA had been trending downward until COVID. That is a puzzle I’m very interested in solving.
Klebsiella spp.
Klebsiella infections also did not appear to have an increasing rate of infection due to COVID. However, an upward trend isn’t good regardless given how this organism is commonly associated with respiratory tract, urinary tract, and wound infections.
Pseudomonas aeruginosa
Pseudomonas aeruginosa is an environmental pathogen found in soil and water. It can cause a number of different types of infections in humans. One concern is that the rate of infections with these organisms was trending downward but is now trending upward. Another emerging concern is a report by Howard et al. about a strain of this organism that has acquired a gene to encode an enzyme that will dissolve a type of plastic that is commonly used in healthcare settings. The organism can obtain ALL of its carbon needs from this plastic. It seems like a story straight from The Andromeda Strain by Michael Crighton.
Escherichia coli
E. coli is a common organism in the gastrointestinal tract. It is also associated with a number of different infections.
Clostridioides difficile (C. diff)
C. diff is an organism that resides in the gastrointestinal tract of about 2-5% of healthy adults. It forms spores, which allow it to survive in harsh environments and make it important to control in healthcare settings. We use the abbreviation CDI for C. diff infection in healthcare. This is another organism where infections had been decreasing before COVID, but now are increasing.
Obviously, none of this proves that COVID immune damage is the cause, but, we do know from multiple studies that COVID causes damage to the immune system, so it is a reasonable assumption that immune damage is playing a role. I have a number of studies quoted and linked here.
