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Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study
OBJECTIVES: Superimposed multi-drug resistant organisms (MDROs) co-infection can be associated with worse outcomes in patients with severe coronavirus disease 2019 (COVID-19), even if these patients were managed with strict airborne and contact precautions. Identifying risk factors for isolation of...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251653/ https://www.ncbi.nlm.nih.gov/pubmed/34146624 http://dx.doi.org/10.1016/j.ajic.2021.06.005 |
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author | Son, Hyo-Ju Kim, Tark Lee, Eunjung Park, Se Yoon Yu, Shinae Hong, Hyo-Lim Kim, Min-Chul Hong, Sun In Bae, Seongman Kim, Min Jae Kim, Sung-Han Yun, Ji Hyun Jo, Kyeong Min Lee, Yu-Mi Lee, Seungjae Park, Jung Wan Jeon, Min Hyok Kim, Tae Hyong Choo, Eun Ju |
author_facet | Son, Hyo-Ju Kim, Tark Lee, Eunjung Park, Se Yoon Yu, Shinae Hong, Hyo-Lim Kim, Min-Chul Hong, Sun In Bae, Seongman Kim, Min Jae Kim, Sung-Han Yun, Ji Hyun Jo, Kyeong Min Lee, Yu-Mi Lee, Seungjae Park, Jung Wan Jeon, Min Hyok Kim, Tae Hyong Choo, Eun Ju |
author_sort | Son, Hyo-Ju |
collection | PubMed |
description | OBJECTIVES: Superimposed multi-drug resistant organisms (MDROs) co-infection can be associated with worse outcomes in patients with severe coronavirus disease 2019 (COVID-19), even if these patients were managed with strict airborne and contact precautions. Identifying risk factors for isolation of MDROs is critical to COVID-19 treatment. METHODS: All eligible adult patients with confirmed COVID-19 pneumonia from 10 hospitals in the Republic of Korea between February 2020 and May 2020 were retrospectively enrolled. Using this cohort, epidemiology and risk factors for isolation of MDROs were evaluated. RESULTS: Of 152 patients, 47 with microbial culture results were included. Twenty isolates of MDROs from 13 (28%) patients were cultured. Stenotrophomonas maltophilia (5 isolates) was the most common MDRO, followed by methicillin-resistant staphylococcus aureus (4 isolates). MDROs were mostly isolated from sputum samples (80%, 16/20). The median time from hospitalization to MDRO isolation was 28 days (interquartile range, 18-38 days). In-hospital mortality was higher in patients with MDRO isolation (62% vs 15%; P = .001). Use of systemic corticosteroids after diagnosis of COVID-19 (adjusted odds ratio [aOR]: 15.07; 95% confidence interval [CI]: 2.34-97.01; P = .004) and long-term care facility (LTCF) stay before diagnosis of COVID-19 (aOR: 6.09; 95% CI: 1.02-36.49; P = .048) were associated with MDRO isolation. CONCLUSIONS: MDROs were isolated from 28% of COVID-19 pneumonia patients with culture data and 8.6% of the entire cohort. Previous LTCF stay and adjunctive corticosteroid use were risk factors for the isolation of MDROs. Strict infection prevention strategies may be needed in these COVID-19 patients with risk factors. |
format | Online Article Text |
id | pubmed-8251653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82516532021-07-02 Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study Son, Hyo-Ju Kim, Tark Lee, Eunjung Park, Se Yoon Yu, Shinae Hong, Hyo-Lim Kim, Min-Chul Hong, Sun In Bae, Seongman Kim, Min Jae Kim, Sung-Han Yun, Ji Hyun Jo, Kyeong Min Lee, Yu-Mi Lee, Seungjae Park, Jung Wan Jeon, Min Hyok Kim, Tae Hyong Choo, Eun Ju Am J Infect Control Major Article OBJECTIVES: Superimposed multi-drug resistant organisms (MDROs) co-infection can be associated with worse outcomes in patients with severe coronavirus disease 2019 (COVID-19), even if these patients were managed with strict airborne and contact precautions. Identifying risk factors for isolation of MDROs is critical to COVID-19 treatment. METHODS: All eligible adult patients with confirmed COVID-19 pneumonia from 10 hospitals in the Republic of Korea between February 2020 and May 2020 were retrospectively enrolled. Using this cohort, epidemiology and risk factors for isolation of MDROs were evaluated. RESULTS: Of 152 patients, 47 with microbial culture results were included. Twenty isolates of MDROs from 13 (28%) patients were cultured. Stenotrophomonas maltophilia (5 isolates) was the most common MDRO, followed by methicillin-resistant staphylococcus aureus (4 isolates). MDROs were mostly isolated from sputum samples (80%, 16/20). The median time from hospitalization to MDRO isolation was 28 days (interquartile range, 18-38 days). In-hospital mortality was higher in patients with MDRO isolation (62% vs 15%; P = .001). Use of systemic corticosteroids after diagnosis of COVID-19 (adjusted odds ratio [aOR]: 15.07; 95% confidence interval [CI]: 2.34-97.01; P = .004) and long-term care facility (LTCF) stay before diagnosis of COVID-19 (aOR: 6.09; 95% CI: 1.02-36.49; P = .048) were associated with MDRO isolation. CONCLUSIONS: MDROs were isolated from 28% of COVID-19 pneumonia patients with culture data and 8.6% of the entire cohort. Previous LTCF stay and adjunctive corticosteroid use were risk factors for the isolation of MDROs. Strict infection prevention strategies may be needed in these COVID-19 patients with risk factors. Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. 2021-10 2021-06-17 /pmc/articles/PMC8251653/ /pubmed/34146624 http://dx.doi.org/10.1016/j.ajic.2021.06.005 Text en © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. 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 | Major Article Son, Hyo-Ju Kim, Tark Lee, Eunjung Park, Se Yoon Yu, Shinae Hong, Hyo-Lim Kim, Min-Chul Hong, Sun In Bae, Seongman Kim, Min Jae Kim, Sung-Han Yun, Ji Hyun Jo, Kyeong Min Lee, Yu-Mi Lee, Seungjae Park, Jung Wan Jeon, Min Hyok Kim, Tae Hyong Choo, Eun Ju Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study |
title | Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study |
title_full | Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study |
title_fullStr | Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study |
title_full_unstemmed | Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study |
title_short | Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study |
title_sort | risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: a multicenter study |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251653/ https://www.ncbi.nlm.nih.gov/pubmed/34146624 http://dx.doi.org/10.1016/j.ajic.2021.06.005 |
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