COVID-19 associated bacterial infections in intensive care unit: a case control study

Abstract

We described the secondary bacterial infections (SBI) among COVID-19 patients in comparison with non-COVID-19 patients. We performed a retrospective case–control study between January 01, 2020 and April 01, 2022. Including the adult patients, who stayed ≥ 72 h in intensive care unit (ICU). In total 405 patients were included, 135 had (33.3%) COVID-19, with similar age and gender. The length of stay in ICU was not different (11.4 vs 8.2, p = 0.109), however mean intubation days were higher among COVID-19 cases (6.5 vs 3.8, p = 0.005), SBI were more common among COVID-19 cases (34% vs 10.7%, p < 0.001). Among the patients with pneumonia, the rate of gram-positive bacteria was higher in COVID-19 group than the control group (39% vs 5%, p = 0.006). The predictors for SBI were having COVID-19 (OR: 2.3, Cl 1.25–4.32, p = 0.008), days of intubation (OR: 1.05, Cl 1.01–1.10, p = 0.004), and being male (OR: 2, Cl 1.12–3.58, p = 0.018). The predictors of mortality were COVID-19 (OR: 2.38, Cl 1.28–4.42, p = 0.006), days of intubation (OR: 1.06, Cl 1.03–1.09, p < 0.001), active hematologic malignancy (OR: 3.1, Cl: 1.33–7.28, p = 0.09), active solid tumors (OR: 2.44, Cl 1.21–4.91, p = 0.012), and coronary artery diseases (OR: 1.8, Cl 1.01–3.52, p = 0.045). The most common SBI in COVID-19 patients were methicillin-sensitive Staphylococcus aureus. No carbapenem-resistant Enterobacterales related infections were detected in COVID-19 patients.