Bacterial and fungal co-infections with SARS-CoV-2 in solid organ recipients: a retrospective study

Abstract

Background SARS-CoV-2, a novel corona virus, has caused clusters of fatal pneumonia worldwide. Immune compromised patients are among the high risk groups with poor prognosis of the disease. The presence of bacterial or fungal co-infections with SARS-CoV-2 is associated with increased mortality. Methods The electronic data of the liver and kidney recipients, hospitalized in COVID-19 intensive care unit in an 8-month period in 2020 were retrospectively assessed. The documented bacterial or fungal infections alongside with outcome and risk factors were recorded and analyzed by binary logistic regression model and multivariate analyses. Results Sixty-Six liver and kidney recipients with positive RT-PCR for SARS-CoV-2 were included this study. Twenty one percent of the patients had at least one episode of co-infection during their COVID-19 course. Bacterial and fungal co-infections contributed to a significantly higher mortality. Urine and sputum were the most common sites of pathogen isolation (45.45% and 36.36%; respectively). The majority of infections were caused by vancomycin- resistant Enterococci (30%). Escherichia coli stood in the next position with 23.3%. Prior hospitalization and high doses of corticosteroids were associated with co-infections (p < 0.001 and p = 0.02; respectively.) Conclusions Bacterial and fungal co-infections with COVID-19 are more prevalent in solid organ recipients compared to the general population. Prior hospitalizations and use of broad-spectrum antimicrobial agents lead to emergence of multi-drug resistant pathogens in this susceptible patient population. Early detection and treatment of co-infections as well as antibiotic stewardship is recommended in solid organ recipients.

Fungal–Bacterial Co-Infections and Super-Infections among Hospitalized COVID-19 Patients: A Systematic Review

“…Nearly all of the articles had clearly defined objectives, but overall, the methodological quality was evaluated to be from poor to fair ( Table 3 ). Four articles were scored as being of good quality [ 6 , 24 , 29 , 30 ], six articles were scored as being of fair quality [ 21 , 25 , 33 , 38 , 39 , 40 ], and the remaining fourteen articles were scored as being of poor quality [ 16 , 18 , 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ].…”

Study of marine microorganism metabolites: new resources for bioactive natural products

“…Infections brought on by pathogenic bacteria have a tremendous impact on human health despite the fact that only a limited number of bacteria may cause them ( Packiavathy et al, 2021 ). Bacterial infections are generally less severe compared to fungal or viral infections ( Shafiekhani et al, 2022 ). However, the issue of antimicrobial resistance is becoming increasingly urgent and surpasses the negative effects of fungal and viral infections ( Dadgostar, 2019 ).…”

Polymicrobial Infections in the Immunocompromised Host: The COVID-19 Realm and Beyond

“…The reported incidence of bacterial co-infection or superinfection is variable, and there is significant heterogeneity in the diagnostic criteria utilized and the cohort included in the literature. Whilst the overall risk of coinfection with SARS-CoV-2 is relatively low, it appears to be more frequent in solid organ transplant recipients [ 27 ]. It is associated with worsening of clinical outcomes [ 28 ] and can, as demonstrated in this case, result in significant morbidity.…”