Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis

Habibzadeh, Adrina; Lankarani, Kamran Bagheri; Farjam, Mojtaba; Akbari, Maryam; Kashani, Seyyed Mohammad Amin; Karimimoghadam, Zeinab; Wang, Kan; Imanieh, M H; Tabrizi, Reza; Ahmadizar, Fariba

doi:10.1007/s12281-022-00439-9

Cited by 12 publications

(4 citation statements)

References 34 publications

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“…The results of antimicrobial susceptibility testing are in accordance with previous COVID-19-related reports, where resistance to third-generation cephalosporins is a common problem and carbapenem resistance is an emerging threat [25]. Similarly, azole-resistant Candida infections are an emerging problem in hospital settings [26]. Antimicrobial overprescribing during the pandemic has increased dramatically.…”

Section: Discussionsupporting

confidence: 87%

Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19

Solís-Huerta,

Martinez-Guerra,

Roman-Montes

et al. 2023

Antibiotics

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Recognition of risk factors for hospital-acquired infections (HAI) in patients with COVID-19 is warranted. We aimed to describe factors associated with the development of HAI in patients with severe COVID-19. We conducted a retrospective cohort study including all adult patients admitted with severe COVID-19 between March 2020 and November 2020. The primary outcome was HAI development. Bivariate and multiple logistic regression models were constructed. Among 1540 patients, HAI occurred in 221 (14%). A total of 299 episodes of HAI were registered. The most common HAI were hospital-acquired/ventilation-associated pneumonia (173 episodes) and primary bloodstream infection (66 episodes). Death occurred in 387 (35%) patients and was more frequent in patients with HAI (38% vs. 23%, p < 0.01). Early mechanical ventilation (aOR 18.78, 95% CI 12.56–28.07), chronic kidney disease (aOR 3.41, 95% CI 1.4–8.27), use of corticosteroids (aOR 2.95, 95% CI 1.92–4.53) and tocilizumab (aOR 2.68, 95% CI 1.38–5.22), age ≥ 60 years (aOR 1.91, 95% CI 1.27–2.88), male sex (aOR 1.52, 95% CI 1.03–2.24), and obesity (aOR 1.49, 95% CI 1.03–2.15) were associated with HAI. In patients with severe COVID-19, mechanical ventilation within the first 24 h upon admission, chronic kidney disease, use of corticosteroids, use of tocilizumab, age ≥ 60 years, male sex, and obesity were associated with a higher risk of HAI.

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Section: Discussionsupporting

confidence: 87%

Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19

Solís-Huerta,

Martinez-Guerra,

Roman-Montes

et al. 2023

Antibiotics

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“…Susceptibility rates to fluconazole in C. glabrata isolates decreased from 62% before the pandemic to 46.1% during the pandemic. In addition, there are increasing reports of C. glabrata resistance to echinocandins [29,30]. Our results show a rate of resistance of C. glabrata to caspofungin of 36.4%.…”

Section: Discussionsupporting

confidence: 53%

“…Similar findings have been reported in studies from Turkey and Kuwait, which have shown an increase in the prevalence of MDR Candida spp. Among CAC patients [11,29,30]. The increased resistance rates are of high clinical significance, as echinocandins are considered first-line agents for empiric treatment of invasive candidiasis [19].…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on the Epidemiology and Outcomes of Candidemia: A Retrospective Study from a Tertiary Care Center in Lebanon

El Zakhem,

Mahmoud,

Zakhour

et al. 2023

JoF

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Invasive fungal infections, notably candidemia, have been associated with COVID-19. The epidemiology of candidemia has significantly changed during the COVID-19 pandemic. We aim to identify the microbiological profile, resistance rates, and outcomes of COVID-19-associated candidemia (CAC) compared to patients with candidemia not associated with COVID-19. We retrospectively collected data on patients with candidemia admitted to the American University of Beirut Medical Center between 2004 and 2022. We compared the epidemiology of candidemia during and prior to the COVID-19 pandemic. Additionally, we compared the outcomes of critically ill patients with CAC to those with candidemia without COVID-19 from March 2020 till March 2022. Among 245 candidemia episodes, 156 occurred prior to the pandemic and 89 during the pandemic. Of the latter, 39 (43.8%) were CAC, most of which (82%) were reported from intensive care units (ICU). Non-albicans Candida (NAC) spp. were predominant throughout the study period (67.7%). Candida auris infection was the most common cause of NAC spp. in CAC. C. glabrata had decreased susceptibility rates to fluconazole and caspofungin during the pandemic period (46.1% and 38.4%, respectively). The mortality rate in the overall ICU population during the pandemic was 76.6%, much higher than the previously reported candidemia mortality rate observed in studies involving ICU patients. There was no significant difference in 30-day mortality between CAC and non-CAC (75.0% vs. 78.1%; p = 0.76). Performing ophthalmic examination (p = 0.002), CVC removal during the 48 h following the candidemia (p = 0.008) and speciation (p = 0.028) were significantly associated with a lower case-fatality rate. The epidemiology of candidemia has been significantly affected by the COVID-19 pandemic at our center. Rigorous infection control measures and proper antifungal stewardship are essential to combat highly resistant species such as C. auris.

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“…can upregulate efflux pumps to survive high concentrations of drugs [ [19] , [20] , [21] ], and the use of high dosages of conventional antifungals can lead to both multi-resistance and severe health complications such as arrhythmias, renal failure, and kidney damage among others [ 5 , 15 ]. Recent studies also underline the high rate of strains resistant to antifungals in patients with COVID [ 22 ]. Therefore, there is a need to investigate novel, effective and rapid approaches to treat fungal biofilm-related infections [ 5 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Real-time monitoring of biofilm growth identifies andrographolide as a potent antifungal compound eradicating Candida biofilms

Žiemytė,

Rodríguez-Díaz,

Ventero-Martín

et al. 2023

Biofilm

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Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis

Cited by 12 publications

References 34 publications

Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19

Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19

The Impact of COVID-19 on the Epidemiology and Outcomes of Candidemia: A Retrospective Study from a Tertiary Care Center in Lebanon

Real-time monitoring of biofilm growth identifies andrographolide as a potent antifungal compound eradicating Candida biofilms

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