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Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome
Bacterial and fungal co-infection has been reported in patients with COVID-19, but there is limited experience on these infections in critically ill patients. The objective of this study was to assess the characteristics and ouctome of ICU-acquired infections in COVID-19 patients. We conducted a ret...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778834/ https://www.ncbi.nlm.nih.gov/pubmed/33389263 http://dx.doi.org/10.1007/s10096-020-04142-w |
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author | Bardi, Tommaso Pintado, Vicente Gomez-Rojo, Maria Escudero-Sanchez, Rosa Azzam Lopez, Amal Diez-Remesal, Yolanda Martinez Castro, Nilda Ruiz-Garbajosa, Patricia Pestaña, David |
author_facet | Bardi, Tommaso Pintado, Vicente Gomez-Rojo, Maria Escudero-Sanchez, Rosa Azzam Lopez, Amal Diez-Remesal, Yolanda Martinez Castro, Nilda Ruiz-Garbajosa, Patricia Pestaña, David |
author_sort | Bardi, Tommaso |
collection | PubMed |
description | Bacterial and fungal co-infection has been reported in patients with COVID-19, but there is limited experience on these infections in critically ill patients. The objective of this study was to assess the characteristics and ouctome of ICU-acquired infections in COVID-19 patients. We conducted a retrospective single-centre, case-control study including 140 patients with severe COVID-19 admitted to the ICU between March and May 2020. We evaluated the epidemiological, clinical, and microbiological features, and outcome of ICU-acquired infections. Fifty-seven patients (40.7%) developed a bacterial or fungal nosocomial infection during ICU stay. Infection occurred after a median of 9 days (IQR 5–11) of admission and was significantly associated with the APACHE II score (p = 0.02). There were 91 episodes of infection: primary (31%) and catheter-related (25%) bloodstream infections were the most frequent, followed by pneumonia (23%), tracheobronchitis (10%), and urinary tract infection (8%) that were produced by a wide spectrum of Gram-positive (55%) and Gram-negative bacteria (30%) as well as fungi (15%). In 60% of cases, infection was associated with septic shock and a significant increase in SOFA score. Overall ICU mortality was 36% (51/140). Infection was significantly associated with death (OR 2.7, 95% CI 1.2–5.9, p = 0.015) and a longer ICU stay (p < 0.001). Bacterial and fungal nosocomial infection is a common complication of ICU admission in patients with COVID-19. It usually presents as a severe form of infection, and it is associated with a high mortality and longer course of ICU stay. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10096-020-04142-w. |
format | Online Article Text |
id | pubmed-7778834 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-77788342021-01-04 Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome Bardi, Tommaso Pintado, Vicente Gomez-Rojo, Maria Escudero-Sanchez, Rosa Azzam Lopez, Amal Diez-Remesal, Yolanda Martinez Castro, Nilda Ruiz-Garbajosa, Patricia Pestaña, David Eur J Clin Microbiol Infect Dis Original Article Bacterial and fungal co-infection has been reported in patients with COVID-19, but there is limited experience on these infections in critically ill patients. The objective of this study was to assess the characteristics and ouctome of ICU-acquired infections in COVID-19 patients. We conducted a retrospective single-centre, case-control study including 140 patients with severe COVID-19 admitted to the ICU between March and May 2020. We evaluated the epidemiological, clinical, and microbiological features, and outcome of ICU-acquired infections. Fifty-seven patients (40.7%) developed a bacterial or fungal nosocomial infection during ICU stay. Infection occurred after a median of 9 days (IQR 5–11) of admission and was significantly associated with the APACHE II score (p = 0.02). There were 91 episodes of infection: primary (31%) and catheter-related (25%) bloodstream infections were the most frequent, followed by pneumonia (23%), tracheobronchitis (10%), and urinary tract infection (8%) that were produced by a wide spectrum of Gram-positive (55%) and Gram-negative bacteria (30%) as well as fungi (15%). In 60% of cases, infection was associated with septic shock and a significant increase in SOFA score. Overall ICU mortality was 36% (51/140). Infection was significantly associated with death (OR 2.7, 95% CI 1.2–5.9, p = 0.015) and a longer ICU stay (p < 0.001). Bacterial and fungal nosocomial infection is a common complication of ICU admission in patients with COVID-19. It usually presents as a severe form of infection, and it is associated with a high mortality and longer course of ICU stay. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10096-020-04142-w. Springer Berlin Heidelberg 2021-01-03 2021 /pmc/articles/PMC7778834/ /pubmed/33389263 http://dx.doi.org/10.1007/s10096-020-04142-w Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Original Article Bardi, Tommaso Pintado, Vicente Gomez-Rojo, Maria Escudero-Sanchez, Rosa Azzam Lopez, Amal Diez-Remesal, Yolanda Martinez Castro, Nilda Ruiz-Garbajosa, Patricia Pestaña, David Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome |
title | Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome |
title_full | Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome |
title_fullStr | Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome |
title_full_unstemmed | Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome |
title_short | Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome |
title_sort | nosocomial infections associated to covid-19 in the intensive care unit: clinical characteristics and outcome |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778834/ https://www.ncbi.nlm.nih.gov/pubmed/33389263 http://dx.doi.org/10.1007/s10096-020-04142-w |
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