Early bacterial co-infection in ARDS related to COVID-19

Kreitmann, Louis; Monard, Céline; Dauwalder, Olivier; Simon, Marie; Argaud, Laurent

doi:10.1007/s00134-020-06165-5

Cited by 81 publications

(86 citation statements)

References 6 publications

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“…If the high rate of coinfection with S. aureus has been well described in Flu [ 4 ], first reported cohorts do not mention bacterial co-infection as a common feature of COVID-19 with pneumonia [ 5 ]. Our findings are consistent with those of two recent series which focused on the early bacterial coinfection associated with SARS-CoV-2 pneumonia, and highlighted that S. aureus was one of the main identified microorganism, using molecular diagnostic tests alone or in association with conventional tests [ 6 , 7 ]. Interestingly, procalcitonin level did not differ between the patients with and without associated bacterial coinfection, as already reported by Kreitmann et al [ 7 ] raising the question of the usefulness of this biomarker to help for identifying early bacterial coinfection during COVID-19 pneumonia.…”

Section: Discussionsupporting

confidence: 92%

Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia

et al. 2021

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Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU). Bacterial coinfection has been reported to be rare. We aimed at describing the rate of bacterial coinfection in critically ill adult patients with severe COVID-19 pneumonia. All the patients with laboratory-confirmed severe COVID-19 pneumonia admitted to the ICU of Tenon University-teaching hospital, from February 22 to May 7th, 2020 were included. Respiratory tract specimens were obtained within the first 48 h of ICU admission. During the study period, 101 patients were referred to the ICU for COVID-19 with severe pneumonia. Most patients (n = 83; 82.2%) were intubated and mechanically ventilated on ICU admission. Overall, 20 (19.8%) respiratory tract specimens obtained within the first 48 h. Staphylococcus aureus was the main pathogen identified, accounting for almost half of the early-onset bacterial etiologies. We found a high prevalence of early-onset bacterial coinfection during severe COVID-19 pneumonia, with a high proportion of S. aureus. Our data support the current WHO guidelines for the management of severe COVID-19 patients, in whom antibiotic therapy directed to respiratory pathogens is recommended. Keywords Coronavirus disease 2019 • Bacterial coinfection • Staphylococcus aureus • Intensive care unit • Pneumonia Abbreviations COVID 19 Coronavirus infectious disease ICU Intensive care unit SAPSII Simplified acute physiology score SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 SOFA Sequential Organ Failure Assessment

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Section: Discussionsupporting

confidence: 92%

Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia

et al. 2021

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“…We observed a higher incidence of nosocomial infections compared to those reported in some recent meta-analysis [5,6,12]. However, when we compared our results with those of studies that only included COVID-19 patients hospitalized in the ICU, we observed more similar results [11,[13][14][15][16]. The occurrence of a nosocomial infection was a late complication, occurring after a median of more than one week of ICU stay.…”

Section: Discussionsupporting

confidence: 71%

Nosocomial infections associated to COVID-19 in the Intensive Care Unit. Clinical characteristics and outcome

Bardi

Pintado

Gómez-Rojo

et al. 2020

Preprint

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Background: Bacterial and fungal co-infection has been reported in patients with COVID-19, but there is limited experience on these infections in critically ill patients.Aim: To assess the characteristics and outcome of ICU-acquired infections in COVID-19 patients.Methods: In this retrospective single-centre, case-control study, we included 140 patients with severe COVID-19 admitted to the ICU between March and May 2020. We evaluated the epidemiological, clinical and microbiological features, and outcome of ICU-acquired infections.Results: Fifty seven patients (40.7%), developed a bacterial or fungal nosocomial infection during ICU stay. Infection occurred after a median of 9 days (IQR 5-11) of admission, and was significantly associated with the APACHE II score (p=0.02). There were 91 episodes of infection: primary (31%) and catheter-related (25%) bloodstream infections were the most frequent, followed by pneumonia (23%), tracheobronchitis (10%) and urinary tract infection (8%), that were produced by a wide spectrum of Gram positive (55%) and Gram negative bacteria (30%) as well as fungi (15%). In 60% of cases, infection was associated with septic shock, and a significant increase in SOFA score. Overall ICU mortality was 36% (51/140). Infection was significantly associated with death (OR 2.7, 95% CI 1.2-5.9, p=0.015), and a longer ICU stay (p<0.001).Conclusions: Bacterial and fungal nosocomial infection is a common complication of ICU admission in patients with COVID-19. It usually presents as a severe form of infection and it is associated with a high mortality and longer course of ICU stay.

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“…We observed a higher incidence of nosocomial infections compared to those reported in some recent meta-analysis [ 5 , 6 , 16 , 17 ]. However, when we compared our results with those of studies that only included COVID-19 patients hospitalized in the ICU, we observed more similar results with incidences ranging between 27 and 37% in several reports [ 15 , 18 – 21 ]. The occurrence of a nosocomial infection was a late complication, occurring after a median of more than 1 week of ICU stay.…”

Section: Discussionsupporting

confidence: 68%