Viral-bacterial pneumonia in COVID-19: clinical and laboratory characteristics of patients and a spectrum of bacterial pathogens

Abstract

Objective. To study the clinical and laboratory data of patients with viral-bacterial pneumonia caused by SARS-CoV-2, to evaluate the spectrum of bacterial causative agents and their sensitivity to antibacterial drugs.Materials and methods. 50 cases of viral-bacterial pneumonia associated with the COVID-19 infection were analyzed. The gender-age structure of patients, clinical and laboratory data, degree of disease severity and concomitant diseases were studied. Microbiological examination of sputum and bronchoalveolar lavage (BAL) was performed by bacteriological method using an automatic microbiological analyzer. Identification of the selected cultures and the determination of their sensitivity to antibacterial drugs were provided.Results. The average age of the patients in the studied group was 71,1 ± 14,8 years. 90% of patients had concomitant diseases, mainly of cardiovascular system. The secondary bacterial infection was diagnosed on 13,0 ± 5,0 day from the disease onset and was characterized by bilateral lung lesions. The most common etiological factors of bacterial pneumonia were the microorganisms of the Enterobacteriaceae family — 37%, Staphylococcus aureus — 23% and Acinetobacter baumannii — 13%. The isolated strains were characterized by drug resistance to aminopenicillins, cephalosporins, fluoroquinolones, aminoglycosides and carbapenems.Conclusion. The high level of resistance of bacterial pneumonia causative agents isolated from patients with SARS-CoV-2 infection to antimicrobial drugs requires wider use of reserve drugs and implementation of other treatment strategies.