Prevalence of bacterial pathogens and potential role in COVID-19 severity in patients admitted to intensive care units in Brazil

Abstract

Secondary bacterial and fungal infections are associated with respiratory viral infections and invasive mechanical ventilation. In Coronavirus disease 2019 (COVID-19), lung injury by SARS-CoV-2 and impaired immune response can provide a favorable environment for microorganism growth and colonization in hospitalized individuals. Recent studies suggest that secondary bacterial pneumonia is a risk factor associated with COVID-19. In Brazil, knowledge about microbiota present in COVID-19 patients is incipient. This work describes the microbiota of 21 COVID-19 patients admitted to intensive care units from two Brazilian centers. We identified respiratory, nosocomial and bacterial pathogens as prevalent microorganisms. Other bacterial opportunistic and commensal species are also represented. Virulence factors of these pathogenic species, metabolic pathways used to evade and modulate immunological processes and the interconnection between bacterial presence and virulence in COVID-19 progression are discussed.Article Summary LineWe identified respiratory, nosocomial and bacterial pathogens as prevalent microorganisms in 21 Brazilian COVID-19 patients admitted to Intensive Care Units. Pathogen virulence factors and immune response evasion metabolic pathways are correlated to COVID-19 severity.

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

“…A thorough search into the literature (January 2020–June 2021) revealed many studies trying to address the AMR issue in the pandemic era. The main issues refer to patients with COVID-19 who may receive antimicrobial therapy (a) without a microbiological confirmation of the bacterial co-infection [ 18 , 31 , 32 , 33 , 34 , 35 , 36 ] and (b) often in the absence of a microbiological confirmation of the diagnosis [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. Lai et al [ 24 ] recorded the consumption of antibiotics in January–June 2019 vs. January–June 2020 in The National Taiwan University Hospital.…”

Interaction Between SARS-CoV-2 and Pathogenic Bacteria

“…Lung damage by COVID-19 and impaired immune response can provide a favorable environment for the proliferation and establishment of microorganisms in hospitalized patients. Studies show that secondary bacterial pneumonia is a potential risk factor for the severity and complications in patients with COVID-19 [ 14 ]. For example, secondary infections have been caused by Stenotrophomonas maltophilia , Klebsiella pneumonia ( K. pneumonia ), or Escherichia coli ( E. coli) with serious complications, such as bacteremia, sepsis and nosocomial pneumonia in patients with SARS [ 15 ].…”

“…So far, the predominant microbial population observed in patients with severe COVID-19 infection includes Burkholderia cepacia complex (BCC), Staphylococcus epidermidis ( S. epidermidis ) , Mycoplasma spp. ( M. hominis, M. orale ), S. pneumoniae , and H. influenzae [ 6 , 14 ]. In addition, viral pathogens such as α herpesvirus 1, rhinovirus B, and human orthomyxovirus, as well as Aspergillus flavus and Candida fungi were isolated from these patients [ 18 , 20 ].…”

“…Response to the inflammation and the damage to endothelial and epithelial lung tissue increase vascular permeability. This condition promotes the entry of bacteria into the alveolar region, resulting in growth and proliferation of specific lung pathogens [ 14 ]. Most of the microbiota in the body of patients with COVID-19 consisted of fifty most common species that are listed in Table 1 .…”

“…Nosocomial pathogens mainly include fungi such as Candida albicans ( C. albicans ), Candida tropicalis ( C. tropicalis ), and bacteria including E. coli and Enterococcus faecalis ( E. faecalis ). The presence of these pathogens are mostly reported from China, France, Iran, and Brazil [ 14 ]. Coprobacillus and Delftia acidovorans were identified among opportunistic microorganisms, which are not usually pathogenic but are associated with catheter-related bacteremia and lung cavities formation [ 24 , 25 ].…”