Super-infection by multiple microorganisms in COVID-19 patients

Abstract

Introduction: This study aimed to describe the clinical characteristics of patients with COVID-19 co-infected with multiple multidrug-resistant bacteria.Methods: Patients hospitalized in the AUNA network between January and May 2021, diagnosed with COVID-19 and at least two other infecting microorganisms, were retrospectively included in the analysis. Clinical and epidemiological data were extracted from clinical records. The susceptibility levels of the microorganisms were determined using automated methods. Antibiotic resistance was established among infecting bacteria accounting for ≥5 isolates.Results: A total of 27 patients (21 male and 6 female patients) met the inclusion criteria, with a maximum of eight co-infecting bacteria or fungi during admission time. Seven patients (25.9%) died, with a higher but not significant lethality among women (50% vs. 19.0%). A total of 15 patients presented at least one established comorbidity, with hypertension being the most frequent. The time elapsed between COVID-19 diagnosis and hospital attendance was 7.0 days, with that of patients with a fatal outcome being longer than that of living patients (10.6 vs. 5.4). Up to 20 different microorganisms were isolated, with Pseudomonas aeruginosa being the most common (34 isolates). In general, antibiotic resistance levels were high, especially in Acinetobacter baumannii isolates, with resistance levels of 88.9% to all antimicrobial agents tested, except colistin (0%).Conclusion: In conclusion, the present results show the presence of multiple microorganisms that co-infect COVID-19 patients. When fatal outcome rates are in the range of other reports, the presence of a series of multidrug-resistant microorganisms is of concern, showing the need to reinforce control measures to limit the expansion of almost untreatable microorganisms.

Discovery of Bacterial Key Genes from 16S rRNA-Seq Profiles That Are Associated with the Complications of SARS-CoV-2 Infections and Provide Therapeutic Indications

“…Although SARS-CoV-2 is the main cause of COVID-19, there are some microbial compositions that are associated with the complications of COVID-19 by their co-infections, super-infections and secondary infections [ 14 , 15 , 16 , 17 , 34 ]. This study aims to explore co-/super-/secondary infections causing bacterial key genes (bKGs) and associated drug molecules through bioinformatics analysis.…”

“…Therefore, these proteins were used as targets/receptors to explore candidate drugs against SARS-CoV-2 infections [ 6 , 9 ]. However, COVID-19 patients with weak immunity may suffer from different complications due to microbial co-infections/super-infections/secondary-infections [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. It should be noted here that co-infections refer to the simultaneous infection with two or more different microbial pathogens [ 14 , 17 ].…”

“…It should be noted here that co-infections refer to the simultaneous infection with two or more different microbial pathogens [ 14 , 17 ]. Super-infection occurs when already infected patients are re-infected with other microbial pathogens [ 15 , 16 ]. Secondary infections occur when already infected patients are re-infected, depending on the outcomes of the first infection [ 14 , 17 , 18 ].…”

“…COVID-19 patients often suffer from different symptoms, including fever [ 19 ], cough [ 20 ], sore throat [ 21 ], congestion or runny nose [ 22 ], difficulty breathing [ 23 ], loss of smell or taste [ 24 ], fatigue [ 21 ], muscle pain [ 25 ], headache [ 26 ], nausea or vomiting [ 27 ], diarrhea [ 28 ], meningitis [ 29 ], pneumonia [ 29 ] that are associated with different microbial pathogens [ 30 , 31 , 32 , 33 ]. Therefore, microbial pathogens may be considered the critical risk factors for different complications and the increasing mortality rates of COVID-19 patients [ 14 , 15 , 16 , 17 , 34 ]. In order to inhibit microbial pathogens, it is required to identify pathogenic genes that may lead to exploring potential inhibitors.…”