Clinical profile of bloodstream infections in COVID-19 patients: a retrospective cohort study

Palanisamy, Naveenraj; Vihari, Nakka; Meena, Durga Shankar; Kumar, Deepak; Midha, Naresh Kumar; Tak, Vibhor; Sharma, Ankur; Bohra, Gopal Krishana; Kothari, Nikhil; Dutt, Naveen; Bhatia, Pradeep; Garg, Mahendra Kumar; Misra, Sanjeev

doi:10.1186/s12879-021-06647-x

Cited by 47 publications

(40 citation statements)

References 31 publications

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“…E. coli was the third most commonly detected bacterial species (9.7%) in both groups of patients, while being the second in non-ICU COVID-19 patients (24.6%), isolated mainly from urine. Similarly, E. coli was previously identified in 16% of COVID-19 patients [ 45 ]. Strains of E. coli isolated from non-ICU patients displayed higher resistance to ampicillin, cephalothin, ciprofloxacin, levofloxacin, and trimethoprim/sulfamethoxazole.…”

Section: Discussionmentioning

confidence: 83%

Bacterial Coinfection and Antibiotic Resistance Profiles among Hospitalised COVID-19 Patients

et al. 2022

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While it is reported that COVID-19 patients are more prone to secondary bacterial infections, which are strongly linked to the severity of complications of the disease, bacterial coinfections associated with COVID-19 are not widely studied. This work aimed to investigate the prevalence of bacterial coinfections and associated antibiotic resistance profiles among hospitalised COVID-19 patients. Age, gender, weight, bacterial identities, and antibiotic sensitivity profiles were collected retrospectively for 108 patients admitted to the intensive care unit (ICU) and non-ICU ward of a single center in Saudi Arabia. ICU patients (60%) showed a significantly higher percentage of bacterial coinfections in sputum (74%) and blood (38%) samples, compared to non-ICU. Acinetobacter baumannii (56%) and Klebsiella pneumoniae (56%) were the most prevalent bacterial species from ICU patients, presenting with full resistance to all tested antibiotics except colistin. By contrast, samples of non-ICU patients exhibited infections with Escherichia coli (31%) and Pseudomonas aeruginosa (15%) predominantly, with elevated resistance of E. coli to piperacillin/tazobactam and trimethoprim/sulfamethoxazole. This alarming correlation between multi-drug resistant bacterial coinfection and admission to the ICU requires more attention and precaution with prescribed antibiotics to limit the spread of resistant bacteria and improve therapeutic management.

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Section: Discussionmentioning

confidence: 83%

Bacterial Coinfection and Antibiotic Resistance Profiles among Hospitalised COVID-19 Patients

et al. 2022

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“… 4 , 5 , 7 Male gender, longer time from hospital admission to ICU, use of anti-inflammatory drugs (tocilizumab, methylprednisolone), mechanical ventilation, renal replacement therapies, and underlying comorbidities were found to be associated with the development of BSI. 4 , 7 , 8 Although the prevalence differs according to series, the most commonly isolated pathogens are Enterobacteriaceae (including multi-drug resistant Klebsiella pneumoniae ), Pseudomonas aeruginosa , Acinetobacter baumannii , staphylococci, and enterococci. 4 , 5 , 7 , 8 Furthermore, BSIs were found to be associated with higher mortality.…”

Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors, and Prognosis of Bloodstream Infections in COVID-19 Patients in Intensive Care: A Single-Center Observational Study

Kurt

Mete

Ürkmez

et al. 2022

J Intensive Care Med

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Background Critically ill COVID-19 patients are prone to bloodstream infections (BSIs). Aim To evaluate the incidence, risk factors, and prognosis of BSIs developing in COVID-19 patients in the intensive care unit (ICU). Methods Patients staying at least 48 h in ICU from 22 March 2020 to 25 May 2021 were included. Demographic, clinical, and laboratory data were analyzed. Results The median age of the sample (n = 470) was 66 years (IQR 56.0-76.0), and 64% were male. The three most common comorbidities were hypertension (49.8%), diabetes mellitus (32.8%), and coronary artery disease (25.7%). Further, 252 BSI episodes developed in 179 patients, and the BSI incidence rate was 50.2 (95% CI 44.3-56.7) per 1000 patient-days. The source of BSI is central venous catheter in 42.5% and lower respiratory tract in 38.9% of the episodes. Acinetobacter baumannii (40%) and carbapenem-resistant Klebsiella pneumoniae (21%) were the most common pathogens. CRP levels were lower in patients receiving tocilizumab. Multivariable analysis revealed that continuous renal replacement therapy, extracorporeal membrane oxygenation, and treatment with a combination of methylprednisolone and tocilizumab were independent risk factors for BSI. The estimated cumulative risk of developing first BSI episode was 50% after 6 days and 100% after 25 days. Of the 179 patients, 149 (83.2%) died, and a statistically significant difference ( p < 0.001) was found in the survival distribution in favor of the group without BSI. Conclusion BSI is a common complication in COVID-19 patients followed in the ICU, and it can lead to mortality. Failure in infection control measures, intensive immunosuppressive treatments, and invasive interventions are among the main factors leading to BSIs.

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“…Langford et al meta-analysis estimated the presence of co-infections in 8.6% of over 30,000 analyzed patients [ 8 ]. Also Palanisamy et al reported secondary bloodstream infections in 8.5% COVID-19 ICU patients [ 22 ]. Similar findings was proved in Rawson’s study of eighteen full texts reporting bacterial/fungal co-infection.…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal meningitis and COVID-19: dangerous coexistence. A case report

Guziejko

Czupryna

Zielenkiewicz-Madejska³

et al. 2022

BMC Infect Dis

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Background SARS-CoV-2 is the major cause of infections in humans since December 2019 and is top of the global health concern currently. Streptococcus pneumoniae is one of the leading pathogens of invasive bacterial diseases, including pneumonia, sepsis, and meningitis. Moreover, this bacteria is mostly responsible for secondary infections subsequent to post-viral respiratory disease. Co-infections with bacterial and viral pathogens are associated with severe course of the disease and are a major cause of mortality. In this report, we describe a rare case of COVID-19 patient with pneumococcal sepsis and meningitis of unsuccessful course. Case presentation A 89-year-old man, not vaccinated against SARS-CoV-2 infection, was diagnosed with COVID-19 pneumonia. Patient required oxygen therapy due to respiratory failure. The initial treatment of viral infection with tocilizumab and dexamethasone allowed for the stabilization of the patient’s condition and improvement of laboratory parameters. On the 9th day of hospitalization the patient’s condition deteriorated. Consciousness disorders and acute respiratory disorders requiring intubation and mechanical ventilation were observed. Brain computed tomography excluded intracranial bleeding. The Streptococcus pneumoniae sepsis with concomitant pneumoniae and meningitis was diagnosed based on microbiological culture of blood, bronchial wash, and cerebrospinal fluid examination. Despite targeted antibiotic therapy with ceftriaxone and multidisciplinary treatment, symptoms of multiple organ failure increased. On the 13th day of hospitalization, the patient died. Conclusions Co-infections with bacterial pathogens appear to be not common among COVID-19 patients, but may cause a sudden deterioration of the general condition. Not only vascular neurological complications, but also meningitis should be always considered in patients with sudden disturbances of consciousness. Anti-inflammatory treatment with the combination of corticosteroids and tocilizumab (or tocilizumab alone) pose a severe risk for secondary lethal bacterial or fungal infections. Thus, treating a high-risk population (i.e. elderly and old patients) with these anti-inflammatory agents, require daily clinical assessment, regular monitoring of C-reactive protein and procalcitonin, as well as standard culture of blood, urine and sputum in order to detect concomitant infections, as rapidly as possible.

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Clinical profile of bloodstream infections in COVID-19 patients: a retrospective cohort study

Cited by 47 publications

References 31 publications

Bacterial Coinfection and Antibiotic Resistance Profiles among Hospitalised COVID-19 Patients

Bacterial Coinfection and Antibiotic Resistance Profiles among Hospitalised COVID-19 Patients

Incidence, Risk Factors, and Prognosis of Bloodstream Infections in COVID-19 Patients in Intensive Care: A Single-Center Observational Study

Pneumococcal meningitis and COVID-19: dangerous coexistence. A case report

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