Risk stratification for selecting empiric antibiotherapy during and after COVID-19

Zahar, Jean‐Ralph; Timsit, Jean‐François

doi:10.1097/qco.0000000000000881

Cited by 3 publications

(3 citation statements)

References 99 publications

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“…Recent research highlighted that patients with sepsis are at risk of developing a nosocomial acquisition of multidrug-resistant pathogens. This is a major healthcare concern due to multiple antibiotic courses that will also alter the microbiome of critically ill patients [ 61 , 62 ]. These nosocomial infections are also linked with the function of a cell type that can play a cornerstone role in the understanding of the clinical progression of patients.…”

Section: Discussionmentioning

confidence: 99%

Parallel Dysregulated Immune Response in Severe Forms of COVID-19 and Bacterial Sepsis via Single-Cell Transcriptome Sequencing

et al. 2023

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Critically ill COVID-19 patients start developing single respiratory organ failure that often evolves into multiorgan failure. Understanding the immune mechanisms in severe forms of an infectious disease (either critical COVID-19 or bacterial septic shock) would help to achieve a better understanding of the patient’s clinical trajectories and the success of potential therapies. We hypothesized that a dysregulated immune response manifested by the abnormal activation of innate and adaptive immunity might be present depending on the severity of the clinical presentation in both COVID-19 and bacterial sepsis. We found that critically ill COVID-19 patients demonstrated a different clinical endotype that resulted in an inflammatory dysregulation in mild forms of the disease. Mild cases (COVID-19 and bacterial non severe sepsis) showed significant differences in the expression levels of CD8 naïve T cells, CD4 naïve T cells, and CD4 memory T cells. On the other hand, in the severe forms of infection (critical COVID-19 and bacterial septic shock), patients shared immune patterns with upregulated single-cell transcriptome sequencing at the following levels: B cells, monocyte classical, CD4 and CD8 naïve T cells, and natural killers. In conclusion, we identified significant gene expression differences according to the etiology of the infection (COVID-19 or bacterial sepsis) in the mild forms; however, in the severe forms (critical COVID-19 and bacterial septic shock), patients tended to share some of the same immune profiles related to adaptive and innate immune response. Severe forms of the infections were similar independent of the etiology. Our findings might promote the implementation of co-adjuvant therapies and interventions to avoid the development of severe forms of disease that are associated with high mortality rates worldwide.

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Section: Discussionmentioning

confidence: 99%

Parallel Dysregulated Immune Response in Severe Forms of COVID-19 and Bacterial Sepsis via Single-Cell Transcriptome Sequencing

et al. 2023

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“…Gram-positive cocci and Gram-negative bacilli in HAP were commonly found in cultures obtained from these patients. The rate of Gram-negative bacilli is particularly high in late-onset ventilator-associated pneumonia, and the specific risk of Pseudomonas aeruginosa-related pneumonia increased when the duration of ventilation was longer than 7 days [21].…”

Section: Bacterial Infections In the Covid-19 Eramentioning

confidence: 99%

Geriatric Sepsis in the COVID-19 Era: Challenges in Diagnosis and Management

Karcıoglu¹,

Yilmaz²,

Kilic³

et al. 2022

Int J Pharm Res Allied Sci

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The elderly or geriatric patients represent a significant portion of emergency department (ED) admissions. Factors affecting poor outcome in these patients suspected or diagnosed with sepsis include shock, hyperlactatemia, and organ failure. Atypical presentations should be emphasized in the training of triage and ED personnel due to difficulties and pitfalls in diagnostic processes for sepsis. The vital organ functions of the elderly, who are among the highest risk groups in the management of sepsis, may deteriorate rapidly with very few precursors, and aggressive methods should be used rapidly when necessary. Interactions of drug doses in the elderly, problems in excretion and differences in metabolism should be considered in treatment regimens. Healthcare workers should try to eliminate colonization risks such as vascular catheterization, unnecessary vascular access and urinary catheters should be removed. In the long term after recovery from sepsis, heart failure, peripheral vascular disease, dementia, and diabetes are the most common entities recorded in the literature. This review was intended to provide an overview of the overall management and give some practical tips for this fragile group of patients in the post-pandemic era.

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“…With the worldwide vaccination projects and the decrease of pathogenicity of SARS-CoV-2 variants, most of the affected patients showed mild symptoms and good prognosis [12,13]. More attention should be paid to patients with severe illness, e.g., those co-infected with bacteria and/or fungi [14]. In this light, this study considered the infection parameters to construct a mortality prediction model.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Tract Pathogen Profiles of COVID-19 Pneumonia Patients and the Mortality Prediction

Liu,

Fan

et al. 2024

Preprint

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Background COVID-19 pneumonia is easily complicated with other respiratory pathogenic attacks, increasing the risk of death. Exploring the pathogen profiles of COVID-19 patients-related facilitated the clinical management and decisions to pursue better prognosis. Methods This study systematically compared the sputum culture results and death events of 170 non-COVID-19 and 197 COVID-19 patients. Statistical analysis was carried out to find the pathogen profile difference between the two populations. The death risk model was constructed for the infected COVID-19. Results It was found that co-infection with bacteria and fungi increased the mortality of COVID-19 pneumonia patients. The isolation rate of Acinetobacter baumannii in COVID-19 patients was significantly higher than that in non-COVID-19 patients and often showed multi-drug resistant phenotypes. The COVID-19 pneumonia patients showed a higher incidence of intensive care unit admission, ventilator-assisted ventilation and death with fungal infection. The serum levels of interleukin-1, interleukin-6, interleukin-8, TNF, lymphocytes, neutrophils and white blood cells in patients with COVID-19 pneumonia decreased. A death prediction model was constructed based on machine learning methods, achieving a prediction accuracy of 90.0%. The main factors affecting the survival rate of COVID-19 pneumonia patients co-infected with other pathogens were admission to the intensive care unit, days of hospital stay, ventilator-aided treatment, carbapenems administration, lymphocyte, serum aspartate aminotransferase level, Acinetobacter baumannii infection, and Candida infection. Conclusions This study provided necessary clinical indicators for timely and precise intervention of COVID-19 pneumonia patients when they were infected by other pathogens. The COVID-19-related secondary infection microorganisms were different compared with the pathogens isolated from non-COVID-19 patients.

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Risk stratification for selecting empiric antibiotherapy during and after COVID-19

Cited by 3 publications

References 99 publications

Parallel Dysregulated Immune Response in Severe Forms of COVID-19 and Bacterial Sepsis via Single-Cell Transcriptome Sequencing

Parallel Dysregulated Immune Response in Severe Forms of COVID-19 and Bacterial Sepsis via Single-Cell Transcriptome Sequencing

Geriatric Sepsis in the COVID-19 Era: Challenges in Diagnosis and Management

Respiratory Tract Pathogen Profiles of COVID-19 Pneumonia Patients and the Mortality Prediction

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