Cargando…

Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital

COVID-19 is associated with prolonged hospitalization and a high risk of intubation, which raises concern for bacterial coinfection and antimicrobial resistance. Previous research has shown a wide range of bacterial pneumonia rates for COVID-19 patients in a variety of clinical and demographic setti...

Descripción completa

Detalles Bibliográficos
Autores principales: Weidmann, Maxwell D., Berry, Gregory J., Zucker, Jason E., Huang, Simian, Sobieszczyk, Magdalena E., Green, Daniel A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297819/
https://www.ncbi.nlm.nih.gov/pubmed/35642519
http://dx.doi.org/10.1128/jcm.00174-22
_version_ 1784750557129342976
author Weidmann, Maxwell D.
Berry, Gregory J.
Zucker, Jason E.
Huang, Simian
Sobieszczyk, Magdalena E.
Green, Daniel A.
author_facet Weidmann, Maxwell D.
Berry, Gregory J.
Zucker, Jason E.
Huang, Simian
Sobieszczyk, Magdalena E.
Green, Daniel A.
author_sort Weidmann, Maxwell D.
collection PubMed
description COVID-19 is associated with prolonged hospitalization and a high risk of intubation, which raises concern for bacterial coinfection and antimicrobial resistance. Previous research has shown a wide range of bacterial pneumonia rates for COVID-19 patients in a variety of clinical and demographic settings, but none have compared hospitalized COVID-19 patients to patients testing negative for severe acute respiratory syndrome coronavirus (SARS-CoV-2) in similar care settings. We performed a retrospective cohort study on hospitalized patients with COVID-19 testing from March 10th, 2020 to December 31st, 2020. A total of 19,219 patients were included, of which 3,796 tested positive for SARS-CoV-2. We found a 2.6-fold increase (P < 0.001) in respiratory culture ordering in COVID-19 patients. On a per-patient basis, COVID-19 patients were 1.5-fold more likely than non-COVID patients to have positive respiratory cultures (46.8% versus 30.9%, P < 0.001), which was primarily driven by patients requiring intubation. Among patients with pneumonia, a significantly higher proportion of COVID-19 patients had ventilator-associated pneumonia (VAP) relative to non-COVID patients (86.3% versus 70.8%, P < 0.001), but a lower proportion had community-acquired (11.2% vs 25.5%, P < 0.01) pneumonia. There was also a significantly higher proportion of respiratory cultures positive for methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, and antibiotic-resistant organisms in COVID-19 patients. Increased rates of respiratory culture ordering for COVID-19 patients therefore appear to be clinically justified for patients requiring intubation, but further research is needed to understand how SARS-CoV-2 increases the risk of VAP.
format Online
Article
Text
id pubmed-9297819
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher American Society for Microbiology
record_format MEDLINE/PubMed
spelling pubmed-92978192022-07-21 Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital Weidmann, Maxwell D. Berry, Gregory J. Zucker, Jason E. Huang, Simian Sobieszczyk, Magdalena E. Green, Daniel A. J Clin Microbiol Bacteriology COVID-19 is associated with prolonged hospitalization and a high risk of intubation, which raises concern for bacterial coinfection and antimicrobial resistance. Previous research has shown a wide range of bacterial pneumonia rates for COVID-19 patients in a variety of clinical and demographic settings, but none have compared hospitalized COVID-19 patients to patients testing negative for severe acute respiratory syndrome coronavirus (SARS-CoV-2) in similar care settings. We performed a retrospective cohort study on hospitalized patients with COVID-19 testing from March 10th, 2020 to December 31st, 2020. A total of 19,219 patients were included, of which 3,796 tested positive for SARS-CoV-2. We found a 2.6-fold increase (P < 0.001) in respiratory culture ordering in COVID-19 patients. On a per-patient basis, COVID-19 patients were 1.5-fold more likely than non-COVID patients to have positive respiratory cultures (46.8% versus 30.9%, P < 0.001), which was primarily driven by patients requiring intubation. Among patients with pneumonia, a significantly higher proportion of COVID-19 patients had ventilator-associated pneumonia (VAP) relative to non-COVID patients (86.3% versus 70.8%, P < 0.001), but a lower proportion had community-acquired (11.2% vs 25.5%, P < 0.01) pneumonia. There was also a significantly higher proportion of respiratory cultures positive for methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, and antibiotic-resistant organisms in COVID-19 patients. Increased rates of respiratory culture ordering for COVID-19 patients therefore appear to be clinically justified for patients requiring intubation, but further research is needed to understand how SARS-CoV-2 increases the risk of VAP. American Society for Microbiology 2022-06-01 /pmc/articles/PMC9297819/ /pubmed/35642519 http://dx.doi.org/10.1128/jcm.00174-22 Text en Copyright © 2022 American Society for Microbiology. https://doi.org/10.1128/ASMCopyrightv2All Rights Reserved (https://doi.org/10.1128/ASMCopyrightv2) . https://doi.org/10.1128/ASMCopyrightv2This article is made available via the PMC Open Access Subset for unrestricted noncommercial 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 Bacteriology
Weidmann, Maxwell D.
Berry, Gregory J.
Zucker, Jason E.
Huang, Simian
Sobieszczyk, Magdalena E.
Green, Daniel A.
Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital
title Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital
title_full Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital
title_fullStr Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital
title_full_unstemmed Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital
title_short Bacterial Pneumonia and Respiratory Culture Utilization among Hospitalized Patients with and without COVID-19 in a New York City Hospital
title_sort bacterial pneumonia and respiratory culture utilization among hospitalized patients with and without covid-19 in a new york city hospital
topic Bacteriology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297819/
https://www.ncbi.nlm.nih.gov/pubmed/35642519
http://dx.doi.org/10.1128/jcm.00174-22
work_keys_str_mv AT weidmannmaxwelld bacterialpneumoniaandrespiratorycultureutilizationamonghospitalizedpatientswithandwithoutcovid19inanewyorkcityhospital
AT berrygregoryj bacterialpneumoniaandrespiratorycultureutilizationamonghospitalizedpatientswithandwithoutcovid19inanewyorkcityhospital
AT zuckerjasone bacterialpneumoniaandrespiratorycultureutilizationamonghospitalizedpatientswithandwithoutcovid19inanewyorkcityhospital
AT huangsimian bacterialpneumoniaandrespiratorycultureutilizationamonghospitalizedpatientswithandwithoutcovid19inanewyorkcityhospital
AT sobieszczykmagdalenae bacterialpneumoniaandrespiratorycultureutilizationamonghospitalizedpatientswithandwithoutcovid19inanewyorkcityhospital
AT greendaniela bacterialpneumoniaandrespiratorycultureutilizationamonghospitalizedpatientswithandwithoutcovid19inanewyorkcityhospital