Coinfections with Other Respiratory Pathogens among Patients with COVID-19

Sreenath, K R; Batra, Priyam; Vinayaraj, E V; Bhatia, Ravi; SaiKiran, Kvp; Singh, Vishwajeet; Singh, Sheetal; Verma, Nishant; Singh, Urvashi; Mohan, Anant; Bhatnagar, Sushma; Trikha, Anjan; Guleria, Randeep; Chaudhry, Rama

doi:10.1128/spectrum.00163-21

Cited by 93 publications

(103 citation statements)

References 36 publications

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“…Isolated strains of K. pneumoniae from blood and urine of ICU patients had complete resistance profiles; however, isolates from sputum samples for the same group presented with no resistance and 62% resistance to colistin and amikacin, respectively. This is in line with findings that the majority of K. Pneumoniae isolated from the blood of ICU patients were multi-drug resistant with high resistance to most used antibiotics [ 44 ].…”

Section: Discussionsupporting

confidence: 90%

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: Discussionsupporting

confidence: 90%

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

et al. 2022

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“…In early 2020, the WHO advocated leveraging existing ILI/SARI surveillance mechanisms like GISRS (Global Influenza Surveillance and Reponse System) for COVID-19 surveillance [ 25 ], and in November 2020, the WHO suggested integration of COVID-19 and influenza surveillance platforms, with a recommendation to test both pathogens simultaneously, preferably with multiplex PCR (Polymerase Chain Reaction) assays [ 26 ]. In line with this, and in view of sporadic reports of high rates of co-infection of SARS-CoV-2 in India [ 27 , 28 ], in July 2021, the ICMR established a pan-India ILI/SARI surveillance network in 22 VRDLs throughout the country. This network is uniquely positioned, as each of the 22 sites is linked with a hospital as well as a defined community catchment area, therefore the surveillance samples are representative of both hospital and community settings.…”

Section: Introductionmentioning

confidence: 83%

SARS-CoV-2 and Influenza Virus Co-Infection Cases Identified through ILI/SARI Sentinel Surveillance: A Pan-India Report

Aggarwal

Potdar

Vijay

et al. 2022

Viruses

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SARS-CoV-2/influenza virus co-infection studies have focused on hospitalized patients who usually had grave sequelae. Here, we report SARS-CoV-2/influenza virus co-infection cases from both community and hospital settings reported through integrated ILI/SARI (Influenza Like Illness/Severe Acute Respiratory Infection) sentinel surveillance established by the Indian Council of Medical Research. We describe the disease progression and outcomes in these cases. Out of 13,467 samples tested from 4 July 2021–31 January 2022, only 5 (0.04%) were of SARS-CoV-2/influenza virus co-infection from 3 different sites in distinct geographic regions. Of these, three patients with extremes of age required hospital admission, but none required ICU admission or mechanical ventilation. No mortality was reported. The other two co-infection cases from community settings were managed at home. This is the first report on SARS-CoV-2/Influenza virus co-infection from community as well as hospital settings in India and shows that influenza viruses are circulating in the community even during COVID-19. The results emphasize the need for continuous surveillance for multiple respiratory pathogens for effective public health management of ILI/SARI cases in line with the WHO (World Health Organization) recommendations.

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“…After applying the inclusion and exclusion criteria ( Figure 1 ), a total of 38 articles were included in the qualitative synthesis [ 23 , 24 , 26 , 28 , 29 , 35 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. More precisely, 27 observational studies (see Table 1 for details), 1 case series, and 10 case reports (see Appendix A for details) were included.…”

Section: Resultsmentioning

confidence: 99%

“…The corresponding share of sampled patients ranged from 2.1% [ 59 ] to 100% [ 27 , 42 , 43 , 45 , 48 , 51 , 53 , 58 , 62 , 63 ] of index cases. In most cases, their status was assessed with Urinary Legionella Antigen Testing (ULAT) (76.7%), but a substantial share of them was also assessed with PCR on bronchial specimens (23.3%).…”

Section: Resultsmentioning

confidence: 99%

“…; Pseudomonas spp. ; Staphilococci , and Enterococci) that may peak at up to 20% of incident cases, the potential occurrence of Legionella infections may therefore appear quite insignificant [ 42 , 43 , 74 ], and substantially lower than that addressed by early reports from mainland China [ 27 ]. Moreover, it should be stressed that nearly half of the sampled cases were from ICUs (i.e., 47.4%), an estimate that exceeds most of the available reports for SARS-CoV-2 infections, even for the “first wave,” [ 75 , 76 ], when Grasselli et al reported a utilization of ICU equal to 16% of all hospitalizations [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

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SARS-CoV-2–Legionella Co-Infections: A Systematic Review and Meta-Analysis (2020–2021)

et al. 2022

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Legionnaires’ Disease (LD) is a severe, sometimes fatal interstitial pneumonia due to Legionella pneumophila. Since the inception of the SARS-CoV-2 pandemic, some contradictory reports about the effects of lockdown measures on its epidemiology have been published, but no summary evidence has been collected to date. Therefore, we searched two different databases (PubMed and EMBASE) focusing on studies that reported the occurrence of LD among SARS-CoV-2 cases. Data were extracted using a standardized assessment form, and the results of such analyses were systematically reported, summarized, and compared. We identified a total of 38 articles, including 27 observational studies (either prospective or retrospective ones), 10 case reports, and 1 case series. Overall, data on 10,936 SARS-CoV-2 cases were included in the analyses. Of them, 5035 (46.0%) were tested for Legionella either through urinary antigen test or PCR, with 18 positive cases (0.4%). A pooled prevalence of 0.288% (95% Confidence Interval (95% CI) 0.129–0.641), was eventually calculated. Moreover, detailed data on 19 co-infections LD + SARS-CoV-2 were obtained (males: 84.2%; mean age: 61.9 years, range 35 to 83; 78.9% with 1 or more underlying comorbidities), including 16 (84.2%) admissions to the ICU, with a Case Fatality Ratio of 26.3%. In summary, our analyses suggest that the occurrence of SARS-CoV-2–Legionella infections may represent a relatively rare but not irrelevant event, and incident cases are characterized by a dismal prognosis.

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Coinfections with Other Respiratory Pathogens among Patients with COVID-19

Cited by 93 publications

References 36 publications

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

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

SARS-CoV-2 and Influenza Virus Co-Infection Cases Identified through ILI/SARI Sentinel Surveillance: A Pan-India Report

SARS-CoV-2–Legionella Co-Infections: A Systematic Review and Meta-Analysis (2020–2021)

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