Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii in patients with COVID-19: Two problems, one solution?

Lima, William Gustavo; Brito, Júlio César Moreira; Nizer, Waleska Stephanie da Cruz

doi:10.1016/j.mehy.2020.110139

Cited by 50 publications

(40 citation statements)

References 24 publications

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“…Similar findings of multi-drug-resistant A. baumannii isolates have been recently mentioned elsewhere in COVID-19 patients in both blood and respiratory isolates, mainly from ICUs in high percentages [ 51 , 52 ]. High rates of resistance were observed in almost all widely used antibiotics in A. baumannii infections, such as carbapenems/meropenem [ 27 , 53 , 54 ], other β-lactams [ 19 , 55 ], aminoglycosides/amikacin [ 19 , 27 , 30 , 54 ] and colistin [ 52 , 53 ]. Tigecycline was also reported to be used in COVID-19 patients with A. baumannii co-infections; susceptible isolates reported in Li et al, 2020 [ 27 ] and Kyriakidis et al [ 52 ]; and resistant isolates in Vijay et al [ 56 ] and Chen et al [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance—WHONET-Greece (January 2018–March 2021)

Polemis

Mandilara

Παππά

et al. 2021

Life

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Changes in hospitals’ daily practice due to COVID-19 pandemic may have an impact on antimicrobial resistance (AMR). We aimed to assess this possible impact as captured by the Greek Electronic System for the Surveillance of Antimicrobial Resistance (WHONET-Greece). Routine susceptibility data of 17,837 Gram-negative and Gram-positive bacterial isolates from blood and respiratory specimens of hospitalized patients in nine COVID-19 tertiary hospitals were used in order to identify potential differences in AMR trends in the last three years, divided into two periods, January 2018–March 2020 and April 2020–March 2021. Interrupted time-series analysis was used to evaluate differences in the trends of non-susceptibility before and after the changes due to COVID-19. We found significant differences in the slope of non-susceptibility trends of Acinetobacter baumannii blood and respiratory isolates to amikacin, tigecycline and colistin; of Klebsiella pneumoniae blood and respiratory isolates to meropenem and tigecycline; and of Pseudomonas aeruginosa respiratory isolates to imipenem, meropenem and levofloxacin. Additionally, we found significant differences in the slope of non-susceptibility trends of Staphylococcus aureus isolates to oxacillin and of Enterococcus faecium isolates to glycopeptides. Assessing in this early stage, through surveillance of routine laboratory data, the way a new global threat like COVID-19 could affect an already ongoing pandemic like AMR provides useful information for prompt action.

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Section: Discussionmentioning

confidence: 99%

COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance—WHONET-Greece (January 2018–March 2021)

Polemis

Mandilara

Παππά

et al. 2021

Life

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“…The data about superinfections complicating COVID-19 are scant, and a significant proportion of these patients are treated with empiric broad spectrum antibiotic therapy that increase the risk to develop infections caused by multidrug-resistant (MDR) pathogens [ 5 , 6 ]. Finally, the use of drugs targeting cytokines, such as IL-1 and IL-6, might also increase the risk of superinfections in patients with COVID-19 [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

et al. 2021

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Objectives Superinfections in patients hospitalized in intensive care unit (ICU) are an important and challenging complication, also in COVID-19. However, no definitive data are available about the role of multidrug-resistant Acinetobacter baumannii (MDR-AB) in COVID-19. Methods This was a single-center, cross-sectional study including patients with MDR-AB infections admitted to ICU with or without COVID-19, between January 2019 and January 2021. The primary objective of the study was to evaluate risk factor for MDR-AB infections in ICU patients hospitalized for COVID-19 or other etiology. The secondary endpoints were 30-days mortality in all study population and risk factors associated with development of bloodstream infection (BSI). Results During the study period 32 adults with COVID-19 were enrolled and compared with 115 patients admitted in the same ICU for other reasons. We observed a total of 114 deaths, with a survival rate of 29.3%: 18.8% in COVID-19 and 32.2% in control group. Relative risk for MDR-AB infection in COVID-19 showed that serum lactate levels mmol/l > 2, Acinetobacter baumannii colonization, BSI and steroid therapy were observed more frequently in COVID-19 patients. Cox regression analysis showed that serum lactate levels > 2 mmol/l, Acinetobacter baumannii colonization, BSI, and steroid therapy were associated with 30-days mortality. Finally, patients with COVID-19, white blood cells count > 11,000 mm3, serum lactate levels > 2 mmol/l, infections at time of ICU admission, Acinetobacter baumannii colonization, and steroid therapy were independently associated with development of BSI. Conclusions Our data highlight the impact of BSI on outcome, the role of Acinetobacter baumannii colonization and the use of steroids on the risk to develop MDR-AB infections also during COVID-19.

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“…1 Although life-saving, MV use can lead to ventilator-associated pneumonia (VAP), with high mortality rates, especially when multidrug-resistant bacteria such as Acinetobacter baumannii are involved. 2,3 Cases of A. baumannii infection were recently reported in COVID-19 patients. 3,4 In Iran, A. baumannii comprised 90% of co-infections with SARS-CoV-2, with mortality rates up to 100%.…”

mentioning

confidence: 99%

Outbreak of endemic carbapenem-resistant Acinetobacter baumannii in a coronavirus disease 2019 (COVID-19)–specific intensive care unit

Shinohara

Saalfeld

Martinez

et al. 2021

Infect. Control Hosp. Epidemiol.

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Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii in patients with COVID-19: Two problems, one solution?

Cited by 50 publications

References 24 publications

COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance—WHONET-Greece (January 2018–March 2021)

COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance—WHONET-Greece (January 2018–March 2021)

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

Outbreak of endemic carbapenem-resistant Acinetobacter baumannii in a coronavirus disease 2019 (COVID-19)–specific intensive care unit

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