Bacterial/fungal infection in hospitalized patients with COVID-19 in a tertiary hospital in the Community of Castilla y León, Spain

Nebreda-Mayoral, Teresa; Miguel-Gómez, María Antonia; March-Rosselló, Gabriel Alberto; Puente-Fuertes, Lucía; Cantón-Benito, Elena; Martínez-García, Ana María; Muñoz-Martín, Ana Belén; Orduña-Domingo, Antonio

doi:10.1016/j.eimce.2022.02.002

Cited by 31 publications

(27 citation statements)

References 27 publications

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“…In addition, while this organism has been reported in many countries as coinfecting COVID-19 patients including Wuhan (China), France, Spain, Iran, Egypt, New York (USA), Italy, and Brazil [ 54 ], it is not mentioned as a primary species in contrast to our study. However, a retrospective COVID-19 study in in Spain showed multidrug-resistant A. baumannii as the leading agent in respiratory infections and bacteremia with outbreak [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Selective COVID-19 Coinfections in Diabetic Patients with Concomitant Cardiovascular Comorbidities Are Associated with Increased Mortality

et al. 2022

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Coinfections and comorbidities add additional layers of difficulties into the challenges of COVID-19 patient management strategies. However, studies examining these clinical conditions are limited. We have independently investigated the significance of associations of specific bacterial species and different comorbidities in the outcome and case fatality rates among 129 hospitalized comorbid COVID-19 patients. For the first time, to best of our knowledge, we report on the predominance of Klebsiella pneumoniae and Acinetobacter baumannii in COVID-19 non-survival diabetic patients The two species were significantly associated to COVID-19 case fatality rates (p-value = 0.02186). Coinfection rates of Klebsiella pneumoniae and Acinetobacter baumannii in non-survivors were 93% and 73%, respectively. Based on standard definitions for antimicrobial resistance, Klebsiella pneumoniae and Acinetobacter baumannii were classified as multidrug resistant and extremely drug resistant, respectively. All patients died at ICU with similar clinical characterisitics. Of the 28 major coinfections, 24 (85.7%) were in non-survivor diabetic patients, implying aggravating and worsening the course of COVID-19. The rates of other comorbidities varied: asthma (47%), hypertension (79.4%), ischemic heart disease (71%), chronic kidney disease (35%), and chronic liver disease (32%); however, the rates were higher in K. pneumoniae and were all concomitantly associated to diabetes. Other bacterial species and comorbidities did not have significant correlation to the outcomes. These findings have highly significant clinical implications in the treatment strategies of COVID-19 patients. Future vertical genomic studies would reveal more insights into the molecular and immunological mechanisms of these frequent bacterial species. Future large cohort multicenter studies would reveal more insights into the mechanisms of infection in COVID-19.

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Section: Discussionmentioning

confidence: 99%

Selective COVID-19 Coinfections in Diabetic Patients with Concomitant Cardiovascular Comorbidities Are Associated with Increased Mortality

et al. 2022

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“…Infection rates reported by other authors were 1.9 to 9.7% [ 14 , 15 , 25 , 26 ]. We have observed that it was particularly difficult to compare UTI rates (3.81% in our study) in COVID-19 patients because the large series in the SARS-COV-2 pandemic did not specifically analyse this type of infection [ 7 , 8 , 12 , 27 ] or the UTI definitions used were different according to the author.…”

Section: Discussionmentioning

confidence: 87%

“…The overall mortality in our study was 26.4%, compared to the initial series of COVID-19 of our hospital, 20.7% [ 18 ], and to the bacterial pneumonia coinfections of our hospital, 54.5% [ 19 ]. In other series including admitted ICU patients, overall mortality ranged between 9.4 and 38% [ 14 , 15 , 26 , 30 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Urinary Tract Infections in Hospitalized COVID-19 Patients, What’s Up, Doc?

Díaz-Pollán

López

Clemente

et al. 2022

JCM

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The SARS-CoV-2 pandemic might have increased the risks of healthcare-associated infections (HAIs); however, several studies of HAI such as urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) have shown contradictory results. The aim of this study is to assess the clinical features of UTIs and bacterial isolates from urine samples of hospitalized COVID-19 patients. We conducted a retrospective observational study including 87 COVID-19 patients with UTIs admitted to our centre. Bacterial UTIs presented were 87: 9 (10.3%) community-acquired UTIs (coinfection group) and 78 (89.6%) hospital-acquired UTIs (superinfection group). In the coinfection group, the most frequent type was non-CAUTI with 5 (55.5%) patients; however, the most frequent UTI in the superinfection group was CAUTI, with 53 (67.9%) patients. The median number of days of hospitalization in coinfected patients was lower than superinfection patients: 13 (IQR 11, 23) vs. 34 days (IQR 23, 47) p < 0.006. All UTI patients admitted to ICU, 38 (43.7%), belonged to the superinfection group. The mortality rate was 26.4% (23/87), 22/23 in the superinfection group. The most common microorganisms were E. coli 27 (28.4%), E. faecalis 25 (26.3%) and E. faecium 20 (21.1%). There was an increased incidence of E. faecalis and E. faecium in UTIs as well as hospital-acquired UTIs. This can be related to urethral catheterization during hospitalization, UCI admissions and the number of days of hospitalization.

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“…[ 8 , 17 ]. This drug is approved by ANVISA (National Health Surveillance Agency) in Brazil for the treatment of serious invasive infections, but it is not included in the Pharmaceutical Assistance list of the Brazilian Unified Health System (SUS) [ 19 ], which makes it promptly access unavailable, and often makes timely treatment unfeasible.…”

Section: Discussionmentioning

confidence: 99%

“…The management of critically ill patients in COVID-19 must consider the rational use of antibiotics and the increased risk of secondary infections [ 3 , 4 , 7 ], even by uncommon emergent pathogens [ 11 , 12 , 18 ]. There is an urgent need to create and implement diagnostic algorithms for the early detection and treatment of secondary infections in COVID-19 patients [ 19 ]. Nebreda-Mayoral and collaborators reflect that despite the use of personal protective equipment, difficulties of overcrowding, the possibility of poorly trained teams and other unfavorable factors that contribute to the emergence of nosocomial infection outbreaks, ongoing review of hospital protocols for infection prevention is mandatory for the control and diagnosis of secondary infections [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Fungal Bloodstream Co-infection by Trichosporon asahii in a COVID-19 Critical Patient: Case Report and Literature Review

et al. 2022

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Opportunistic infections are serious complications in critically ill COVID-19 patients, especially co-infections with bacterial and fungal agents. Here we report a rare case of bloodstream co-infection by Trichosporon asahii , an emerging yeast, and Acinetobacterbaumannii, an opportunistic nosocomial pathogen, both multidrug resistant, in a tertiary hospital from southern Brazil. A review of the literature regarding similar cases is also included. Treatment with multiple antimicrobials failed, and the patient progressed to death four days after the diagnosis of bacteremia and fungemia.

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Bacterial/fungal infection in hospitalized patients with COVID-19 in a tertiary hospital in the Community of Castilla y León, Spain

Cited by 31 publications

References 27 publications

Selective COVID-19 Coinfections in Diabetic Patients with Concomitant Cardiovascular Comorbidities Are Associated with Increased Mortality

Selective COVID-19 Coinfections in Diabetic Patients with Concomitant Cardiovascular Comorbidities Are Associated with Increased Mortality

Urinary Tract Infections in Hospitalized COVID-19 Patients, What’s Up, Doc?

Fungal Bloodstream Co-infection by Trichosporon asahii in a COVID-19 Critical Patient: Case Report and Literature Review

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