The Influence of COVID-19 on the Composition and Drug Resistance of Pleural Effusion in Shandong Province

Abstract

To analyze the composition and drug resistance changes of pleural effusion in Shandong region from 2017 to 2024, and to provide a basis for clinical empirical treatment and future public health strategies. Uese the WHONET5.6 software to analyze the data reported by the SPARSS network. A total of 6336 pathogens was isolated, 3876 were Gram-positive bacteria and 2211 were Gram-negative bacteria. The top five pathogens are Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae, Streptococcus constellatus, and Escherichia coli. The main pathogens in male patients are S. constellatus, S. epidermidis, and K. pneumoniae, while in female patients, they are mainly S. aureus, S. epidermidis, and E. coli. The detection rate of S. constellatus rose from 4.3% to 8.1% after the COVID-19 pandemic (p < 0.0001); K. pneumoniae rose from 6.9% to 8.9%(p = 0.0264), and its resistance rate to meropenem increased from 2.1% to 18.3% (p = 0.0063). The detection rate of methicillin-resistant Staphylococcus aureus has remained largely unaffected by the COVID-19. The resistance rate of Candida albicans to fluconazole is as high as 12.5%. The pathogen spectrum of pleural effusion in Shandong Province is mainly Gram-positive bacteria. Coagulase-negative staphylococci were among the most common isolates, yet their role as true pathogens versus culture contaminants remains to be clarified in clinical practice. Moreover, after the epidemic, the carbapenem resistance of K. pneumoniae has significantly increased, and the problem of fungal drug resistance also needs to be paid attention to continuous monitoring to guide the rational use of drugs in clinical practice.

Keywords: COVID‐19; coagulase‐negative staphylococci; contamination; drug resistance rate; pleural effusion.