Reducing broad-spectrum antibiotic use in intensive care unit between first and second waves of COVID-19 did not adversely affect mortality

Chan, Xin Hui S; O'Connor, Cavan; Martyn, Emily; Clegg, A J; Choy, Bennett; Soares, A L; Shulman, Robert; Stone, Neil; De, Surya K.; Bitmead, James; Hail, Leila; Brealey, David; Arulkumaran, Nishkantha; Singer, Mervyn; Wilson, Andrew

doi:10.1016/j.jhin.2022.03.007

Cited by 10 publications

(8 citation statements)

References 22 publications

(26 reference statements)

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“…Our meta-analysis included nine el-igible studies in the field plus the current study (total of ten studies) (23)(24)(25)(26)(27)(28)(29)(30)(31) after an electronic search and removing duplicate and irrelevant records. The distribution of each survey by country is as follows: Spain, USA, Iran, Saudi Arabia, UK, Italy, a multicenter study from Italy, Croatia, Serbia, Slovenia, and two studies from Turkey.…”

Section: Meta-analysismentioning

confidence: 99%

Bacterial and fungal coinfections among patients with COVID-19 in Zanjan, Northwest of Iran; a single-center observational with meta-analysis of the literature

Morovati¹,

Eslami²,

Bonab³

et al. 2022

IJM

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Background and Objectives: There is a poor understanding about the prevalence and characteristics of secondary bacterial and fungal infections among Coronavirus diseases 2019 (COVID-19) superinfection in hospitalized patients. Materials and Methods: Four hundred COVID-19-proven patients were enrolled in this study. Nasal swabs for molecular assay (Real-time PCR) and sputum samples for further microbiological assays were collected. Following a broad-spectrum search, a meta-analysis was performed using StatsDirect software (version 2.7.9) according to the DerSimonian and Laird method applying the random-effects models. Results: Streptococcus spp. (21.5%) and Staphylococcus spp. (16.7%) had the highest prevalence of bacterial coinfection among the COVID-19 patients,while Acinetobacter spp. had the lowest prevalence (4.2%). Among fungal coinfections, Candida albicans was the most prevalent (6.7%), and Aspergillus spp.was the lowest (2%). Males, elderly patients, patients with a history of underlying diseases and drug use, patients who showed acute clinical symptoms, andpatients with a pro- longed hospital stay had a higher incidence of secondary infections (P-value <0.05). The pooled prevalence for bacterial and fungal coinfections was 33.52% (95% CI: 18.12 to 50.98; I2: 99.4%; P-value: <0.0001). Conclusion: We suggest designing additional research with a larger target population and diagnostic molecular analyses to depict a more realistic view of the coinfection status.

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Section: Meta-analysismentioning

confidence: 99%

Bacterial and fungal coinfections among patients with COVID-19 in Zanjan, Northwest of Iran; a single-center observational with meta-analysis of the literature

Morovati¹,

Eslami²,

Bonab³

et al. 2022

IJM

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“…Enterobacter spp. Amikacin, ciprofloxacin, colistin, ertapenem, imipenem, meropenem, penicillin, sulfamethoxazoletrimethoprim Urinary tract infection, bloodstream infection [38,94,98] Previous studies have associated higher mortality in patients due to bacterial co-infections in influenza [100]. In addition, death cases of patients with COVID-19 along with bacterial co-infections have also been frequently reported [101].…”

Section: Excessive and Reckless Medical Prescription In The Covid-19 ...mentioning

confidence: 99%

Les misérables: a Parallel Between Antimicrobial Resistance and COVID-19 in Underdeveloped and Developing Countries

Jorge

Goes

Gontijo

2022

Curr Infect Dis Rep

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Purpose of Review The COVID-19 pandemic has been responsible for more than 6.3 million deaths worldwide. During the pandemic, the indiscriminate use of antibiotics has increased, contributing to the spread of multidrug-resistant bacteria. In this review, we aim to determine the spread and impact of antibiotic treatments in patients with COVID-19, focusing on underdeveloped and developing countries. Recent Findings Meta-analysis revealed that bacterial co-infections and secondary infections are relatively rare in COVID-19 patients, corresponding to less than 20% of hospitalized patients. Even so, most of these patients have received antibiotic treatments. Summary This review discusses how the COVID-19 pandemic could increase the emergence of multidrug-resistant strains to currently available antibiotics. Initially, we discussed the spread and impact of multidrug resistance of ESKAPE pathogens associated with nosocomial infections and analyzed their risk of secondary infections in patients with COVID-19. Then we highlight three factors related to the spread of resistant bacteria during the current pandemic: overprescription of antibiotics followed by self-medication. Finally, we discussed the lack of availability of diagnostic tests to discriminate the etiologic agent of a disease. All these factors lead to inappropriate use of antibiotics and, therefore, to an increase in the prevalence of resistance, which can have devastating consequences shortly. The data compiled in this study underscore the importance of epidemiological surveillance of hospital isolates to provide new strategies for preventing and controlling infections caused by multidrug-resistant bacteria. In addition, the bibliographic research also highlights the need for an improvement in antibiotic prescribing in the health system.

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“…Median LOS in survivors was seven days (IQR 5−14). Surviving patients that developed a HAI had longer LOS (median of 27 days [IQR 20−42] versus 7 days [5][6][7][8][9][10][11], p < 0.01). IMV during follow-up occurred in 131 patients, of which 58/131 (44.2%) developed HAI, and 73/131 (55.7%) did not (p = 0.187).…”

Section: Resultsmentioning

confidence: 99%

“…Antibiotic overuse in hospitalized patients with COVID-19 may have affected the ecological and epidemiological trends of HAI [9]. Additionally, increasing frequencies of multidrug-resistant (MDR) isolates have been reported [10].…”

Section: Introductionmentioning

confidence: 99%

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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Reducing broad-spectrum antibiotic use in intensive care unit between first and second waves of COVID-19 did not adversely affect mortality

Cited by 10 publications

References 22 publications

Bacterial and fungal coinfections among patients with COVID-19 in Zanjan, Northwest of Iran; a single-center observational with meta-analysis of the literature

Bacterial and fungal coinfections among patients with COVID-19 in Zanjan, Northwest of Iran; a single-center observational with meta-analysis of the literature

Les misérables: a Parallel Between Antimicrobial Resistance and COVID-19 in Underdeveloped and Developing Countries

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

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