Bacterial profiles and their antibiotic resistance background in superinfections caused by multidrug‐resistant bacteria among COVID‐19 ICU patients from southwest Iran

Akrami, Sousan; Montazeri, Effat Abbasi; Saki, Morteza; Neisi, Niloofar; Khedri, Reza; Dini, Sahar Allah; Motlagh, Atefeh Akbari; Ahmadi, Fatemeh

doi:10.1002/jmv.28403

Cited by 5 publications

(4 citation statements)

References 56 publications

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“…The possible reason was that we focused on older people. Another study reported that 72.7% of the COVID-19 ICU patients had secondary infection (Akrami et al, 2023), which was higher than reported in this study. The possible reason might be due to widespread usage of mechanical ventilator that expose patients to infection.…”

Section: Discussioncontrasting

confidence: 72%

Secondary pulmonary infection and co-infection in elderly COVID-19 patients during the pandemics in a tertiary general hospital in Beijing, China

Zhou,

Jiang,

Sun

et al. 2023

Front. Microbiol.

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BackgroundMost people are infected with COVID-19 during pandemics at the end of 2022. Older patients were more vulnerable. However, the incidence of secondary bacterial, fungal or viral pulmonary infection and co-infection is not well described in elderly hospitalized COVID-19 patients.MethodsWe retrospectively reviewed the medical records of all elderly (≥65 years) hospitalized patients with laboratory-confirmed COVID-19 from December 1, 2022 to January 31, 2023. Demographics, underlying diseases, treatments, and laboratory data were collected. Univariate and multivariate logistic regression models were used to explore the risk factors associated with secondary bacterial, fungal or viral pulmonary infection and co-infection.ResultsA total of 322 older patients with COVID-19 were enrolled. The incidence of secondary bacterial, fungal or viral pulmonary infection and co-infection was 27.3% (88/322) and 7.5% (24/322), respectively. The overall in-hospital mortality of all patients was 32.9% (106/322), and the in-hospital mortality among patients who acquired with secondary pulmonary infection and co-infection was 57.0% (57/100). A total of 23.9% (77/322) of patients were admitted to ICU within 48 h of hospitalization. The incidence of secondary pulmonary infection and co-infection among patients admitted to the ICU was 50.6% (39/77) and 13.0% (10/77), respectively. The overall in-hospital mortality of ICU patients was 48.1% (37/77), and the in-hospital mortality of ICU patients acquired with secondary pulmonary infection and co-infection was 61.4% (27/44). A total of 83.5% (269/322) of the included patients received empirical antibiotic therapy before positive Clinical Microbiology results. Influenza A virus (the vast majority were the H3N2 subtype) was the most common community acquired pathogen for co-infection. While A. baumannii, K. pneumoniae, and P. aeruginosa were the common hospital acquired pathogens for co-infection and secondary pulmonary infection. The incidence of Carbapenem-resistant Gram-negative bacilli (CR-GNB) infections was high, and the mortality reached 76.9%. Predictors of secondary pulmonary infection and co-infection were ICU admission within 48 h of hospitalization, cerebrovascular diseases, critical COVID-19, and PCT > 0.5 ng/mL.ConclusionThe prognosis for elderly hospitalized COVID-19 patients with secondary pulmonary infection or co-infection is poor. The inflammatory biomarker PCT > 0.5 ng/mL played an important role in the early prediction of secondary pulmonary infection and co-infection in COVID-19 patients.

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Section: Discussioncontrasting

confidence: 72%

Secondary pulmonary infection and co-infection in elderly COVID-19 patients during the pandemics in a tertiary general hospital in Beijing, China

Zhou,

Jiang,

Sun

et al. 2023

Front. Microbiol.

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“…Also, in Iran, a study conducted on COVID-19 patients admitted to the intensive care unit (ICU) revealed that the Gram-negative bacteria were more predominant than the Gram-positive pathogens. Klebsiella pneumoniae (28.4%) was the most common isolate followed by Staphylococcus aureus (22.4%) [30]. But Gram-positive organisms represented the majority of infections found in a study in both the blood and sputum cultures in USA [31].…”

Section: Discussionmentioning

confidence: 91%

“…Similarly, a study in Iran revealed increased concomitant infections by MDR bacteria (68.7%, 46/67) among COVID-19 patients. More than 70.0% of the Gram-positive and Gram-negative isolates were resistant to most antibiotics, including fluoroquinolone, carbapenems, and cephalosporins [30]. Also, in Saudi Arabia, ICU patients which had coinfections with Gram-negative bacteria, showed high resistance to all tested antibiotics except colistin [32].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of respiratory bacterial co-infection among COVID-19 patients

Mohamed,

Elashry,

Fahim

2023

Microbes and Infectious Diseases

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Background and rationale: Since the beginning of COVID-19 pandemic, the number of cases and deaths increased. Bacterial co-infection was reported as one of the complications associated with increased mortality. This work aimed at exploring and describing the prevalence of respiratory bacterial co-infection among COVID-19 patients in Ain Shams University Isolation Hospitals. Methodology: This study included 160 lower respiratory samples collected from 80 COVID-19 positive patients, and 80 COVID-19-negative patients admitted to Ain Shams University Isolation Hospitals between February and June 2021. Samples were cultured, and all recovered isolates were identified and tested for antibiotic susceptibility using Vitek2C. Results: Our results showed high prevalence of respiratory bacterial infections in males (106/160, 66.2%) than in females (54/160, 33.8%). The age ranged from 25-88 years (mean age 58.24 ± 14.19). In COVID-19-positive patients, 16/80 (20%) samples showed negative bacterial growth, and 64/80 (80%) were positive. In COVID-19-negative patients, 33/80 (41.25%) samples showed negative bacterial growth, and 47 (58.75%) showed bacterial growth. Klebsiella spp. was the most common isolated organism (51/148, 25.9%), followed by Acinetobacter spp. (50/148, 25.4%), and Stenotrophomonas (1/148, 0.5%) was the least common one. As per the Antibiotic susceptibility testing, a high resistance pattern was noticed among the isolated bacteria against all the tested antibiotics. Conclusion: COVID-19-positive patients showed higher positive bacterial growth than COVID-19 patients. Generally, a high resistance pattern was noticed among the isolated bacteria. The obtained results are alarm to the clinicians that they should halt the usage of empirical antimicrobials promptly and resort to culture and antimicrobial susceptibility testing.

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“…it may lead to severe respiratory distress syndrome and presence linked and more severe kidney, damage prolonged artificial breathing, and longer I.C.U. admission (Akrami et al, 2023).…”

Section: Resultsmentioning

confidence: 99%

Mortality Rate and Antibiotic Resistant of the Secondary Bacterial-Infection in SARS-CoV-2 Patients

Hameed,

Kadhum,

Beden

2024

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The main concern for SARS-CoV-2 patients is developing a bacterial secondary infection that could lead to an over whelming infections which very difficult to counteract during the course of the infection. The primary aim of the study at evaluating the most common secondary pathogens ,their antibiotic resistant profile and mortality rate of SARS-CoV-2 patients. A total of 41 patients with ventilator associated pneumonia of whom 23 were confirmed positive. for SARS-CoV-2 (infectious group) and 18 were tested negative for SARS-CoV-2 (non-infectious), were recruited in this study during the period from February to September 2022 at Al-Hussein. Teaching Hospital in Thi-Qar province, Iraq. Endotracheal aspirate samples were collected for the presence of microbes, using traditional cultivation methods along with antibiotic susceptibility testing for cultivated microbes. Using online sequential organ failure assessment score calculator to predict the outcome of the patients involved. A total of 41 patients the in I.C.U. suffers ventilator-associated pneumonia in this study, of whom 23 were infectious and 18 were non-infectious. The infectious group had higher sequential organ failure (SOFA) scores (p<0.05) and more Acinetobacter infections than the noninfectious group. The overuse of broad-spectrum antibiotics in treating bacterial co-infections, especially in intensive care units, is the main reasons of Multi drugs resistance (MDR) bacterial infections. These infections can worsen the clinical outcomes of SARS-CoV-2 patients, resulting in prolonged hospital stays, the need for mechanical ventilation, and higher mortality rates. Additionally, weakened immune systems due to viral infections can also make individuals more susceptible to MDR bacterial infections.

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Bacterial profiles and their antibiotic resistance background in superinfections caused by multidrug‐resistant bacteria among COVID‐19 ICU patients from southwest Iran

Cited by 5 publications

References 56 publications

Secondary pulmonary infection and co-infection in elderly COVID-19 patients during the pandemics in a tertiary general hospital in Beijing, China

Secondary pulmonary infection and co-infection in elderly COVID-19 patients during the pandemics in a tertiary general hospital in Beijing, China

Prevalence of respiratory bacterial co-infection among COVID-19 patients

Mortality Rate and Antibiotic Resistant of the Secondary Bacterial-Infection in SARS-CoV-2 Patients

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