Low incidence of co-infection, but high incidence of ICU-acquired infections in critically ill patients with COVID-19

Abstract

Low incidence of co-infection, but high incidence of ICU-acquired infections in critically ill patients with COVID-19

High rate of infections during ICU admission of patients with severe SARS-CoV-2 pneumonia: A matter of time?

“…Other identified isolates were Pseudomonas aeruginosa, Serratia marcescens and Enterococcus faecium (mostly in respiratory samples), microorganisms that are frequently nosocomial. These data contrast with the low rates reported by other authors in Spain 6 , 7 and focus on the peculiarity of critical patients also in this scenario. Likewise, it should be noted that the hospital stay before admission to the ICU of the patients with P. aeruginosa infection was markedly longer (median 9 days) than that of the general group (median 3 days).…”

“…without difference regardless the presence of an infection, in contrast to what it was observed by other authors. 6 , 10 …”

ICU-acquired bloodstream infections in critically ill patients with COVID-19

“…The observed incidence of 40% of bacterial BSIs is in contrast with that of 11.9% in New York City hospitals [ 4 ] as well as with an 8.1% of secondary infections in a meta-analysis [ 5 ], both proportions reported on COVID-ICU patients. Nevertheless, it is comparable with subsequent findings showing an incidence of ICU-acquired infections up to 51.2%, including a BSI rate at 30.7% [ 2 ]; also, with a reported increase in Gram-negative BSIs identified in COVID-ICUs [ 6 ]; as well as with an estimated risk of 25% for BSI within 15 days after COVID-ICU admission [ 7 ].…”

“…In the context of the COVID-19 pandemic, information concerning secondary infections is so far scarce and variable. While a low rate has been reported in patients with COVID-19 during hospitalization [ 1 ], this proportion increases in studies including intensive care unit (ICU) patients [ 2 ]. Furthermore, admission to ICUs with increased antimicrobial resistance is of concern.…”

Bacterial superinfection pneumonia in SARS-CoV-2 respiratory failure

“…Few studies have addressed VAP complicating severe SARS-CoV-2 pneumonia, with prevalence estimates ranging between 28.6% and 38%. 25,[28][29][30] In our cohort, 44% were diagnosed with at least one episode of VAP. The slightly higher prevalence rate of VAP is likely attributable to the use of the multiplex PCR technology.…”