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The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study

INTRODUCTION: We evaluated the prevalence, aetiologies and antibiotic resistance patterns of bacterial infections in hospitalized patients with laboratory-confirmed SARS-CoV-2. We also investigated comorbidities, risk factors and the mortality rate in COVID-19 patients with bacterial infections. MET...

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Autores principales: Gajic, I., Jovicevic, M., Popadic, V., Trudic, A., Kabic, J., Kekic, D., Ilic, A., Klasnja, S., Hadnadjev, M., Popadic, D.J., Andrijevic, A., Prokic, A., Tomasevic, R., Ranin, L., Todorovic, Z., Zdravkovic, M., Opavski, N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140260/
https://www.ncbi.nlm.nih.gov/pubmed/37121488
http://dx.doi.org/10.1016/j.jhin.2023.04.013
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author Gajic, I.
Jovicevic, M.
Popadic, V.
Trudic, A.
Kabic, J.
Kekic, D.
Ilic, A.
Klasnja, S.
Hadnadjev, M.
Popadic, D.J.
Andrijevic, A.
Prokic, A.
Tomasevic, R.
Ranin, L.
Todorovic, Z.
Zdravkovic, M.
Opavski, N.
author_facet Gajic, I.
Jovicevic, M.
Popadic, V.
Trudic, A.
Kabic, J.
Kekic, D.
Ilic, A.
Klasnja, S.
Hadnadjev, M.
Popadic, D.J.
Andrijevic, A.
Prokic, A.
Tomasevic, R.
Ranin, L.
Todorovic, Z.
Zdravkovic, M.
Opavski, N.
author_sort Gajic, I.
collection PubMed
description INTRODUCTION: We evaluated the prevalence, aetiologies and antibiotic resistance patterns of bacterial infections in hospitalized patients with laboratory-confirmed SARS-CoV-2. We also investigated comorbidities, risk factors and the mortality rate in COVID-19 patients with bacterial infections. METHODS: This retrospective observational study evaluated medical records of 7249 randomly selected patients with COVID-19 admitted to three clinical centres between 1(st) January 2021 and 16(th) February 2022. A total of 6478 COVID-19 patients met the eligibility criteria for analysis. RESULTS: The mean age of the patients with SARS-CoV-2 and bacterial infections was 68.6 ± 15.5 years (range: 24–94 years). The majority of patients (68.7%) were older than 65 years. The prevalence of bacterial infections among hospitalized COVID-19 patients was 12.9%, most of them being hospital-acquired (11.5%). Bloodstream (37.7%) and respiratory tract infections (25.6%) were the most common bacterial infections. Klebsiella pneumoniae and Acinetobacter baumannii caused 25.2% and 23.6% of all bacterial infections, respectively. Carbapenem-resistance in Enterobacterales, A. baumannii and Pseudomonas aeruginosa were 71.3%, 93.8% and 69.1%, respectively. Age >60 years and infections caused by ≥3 pathogens were significantly more prevalent among deceased patients compared with survivors (P<0.05). Furthermore, 95% of patients who were intubated developed ventilator-associated pneumonia. The overall in-hospital mortality rate of patients with SARS-CoV-2 and bacterial infections was 51.6%, while 91.7% of patients who required invasive mechanical ventilation died. CONCLUSIONS: Our results reveal a striking association between healthcare-associated bacterial infections as an important complication of COVID-19 and fatal outcomes.
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spelling pubmed-101402602023-04-28 The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study Gajic, I. Jovicevic, M. Popadic, V. Trudic, A. Kabic, J. Kekic, D. Ilic, A. Klasnja, S. Hadnadjev, M. Popadic, D.J. Andrijevic, A. Prokic, A. Tomasevic, R. Ranin, L. Todorovic, Z. Zdravkovic, M. Opavski, N. J Hosp Infect Article INTRODUCTION: We evaluated the prevalence, aetiologies and antibiotic resistance patterns of bacterial infections in hospitalized patients with laboratory-confirmed SARS-CoV-2. We also investigated comorbidities, risk factors and the mortality rate in COVID-19 patients with bacterial infections. METHODS: This retrospective observational study evaluated medical records of 7249 randomly selected patients with COVID-19 admitted to three clinical centres between 1(st) January 2021 and 16(th) February 2022. A total of 6478 COVID-19 patients met the eligibility criteria for analysis. RESULTS: The mean age of the patients with SARS-CoV-2 and bacterial infections was 68.6 ± 15.5 years (range: 24–94 years). The majority of patients (68.7%) were older than 65 years. The prevalence of bacterial infections among hospitalized COVID-19 patients was 12.9%, most of them being hospital-acquired (11.5%). Bloodstream (37.7%) and respiratory tract infections (25.6%) were the most common bacterial infections. Klebsiella pneumoniae and Acinetobacter baumannii caused 25.2% and 23.6% of all bacterial infections, respectively. Carbapenem-resistance in Enterobacterales, A. baumannii and Pseudomonas aeruginosa were 71.3%, 93.8% and 69.1%, respectively. Age >60 years and infections caused by ≥3 pathogens were significantly more prevalent among deceased patients compared with survivors (P<0.05). Furthermore, 95% of patients who were intubated developed ventilator-associated pneumonia. The overall in-hospital mortality rate of patients with SARS-CoV-2 and bacterial infections was 51.6%, while 91.7% of patients who required invasive mechanical ventilation died. CONCLUSIONS: Our results reveal a striking association between healthcare-associated bacterial infections as an important complication of COVID-19 and fatal outcomes. The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. 2023-07 2023-04-28 /pmc/articles/PMC10140260/ /pubmed/37121488 http://dx.doi.org/10.1016/j.jhin.2023.04.013 Text en © 2023 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Gajic, I.
Jovicevic, M.
Popadic, V.
Trudic, A.
Kabic, J.
Kekic, D.
Ilic, A.
Klasnja, S.
Hadnadjev, M.
Popadic, D.J.
Andrijevic, A.
Prokic, A.
Tomasevic, R.
Ranin, L.
Todorovic, Z.
Zdravkovic, M.
Opavski, N.
The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study
title The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study
title_full The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study
title_fullStr The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study
title_full_unstemmed The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study
title_short The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study
title_sort emergence of multi-drug-resistant bacteria causing healthcare-associated infections in covid-19 patients: a retrospective multi-centre study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140260/
https://www.ncbi.nlm.nih.gov/pubmed/37121488
http://dx.doi.org/10.1016/j.jhin.2023.04.013
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