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Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia
Background: Superinfections contribute to mortality and length of stay in critically ill COVID-19 patients. The aim of this study was to determine the incidence and pathogen distribution of bacterial and fungal superinfections of the lower respiratory tract (LRTI), urinary tract (UTI) and bloodstrea...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497731/ https://www.ncbi.nlm.nih.gov/pubmed/36140471 http://dx.doi.org/10.3390/diagnostics12092069 |
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author | Ćurčić, Maja Tarle, Marko Almahariq, Hani Hleb, Sonja Havaš, Juraj Pražetina, Marko Lasić, Hrvoje Dolenc, Emil Kukoč, Andrea Mihelčić, Antonija Miko, Ivan Romić, Andrea Tipura, Danijela Drmić, Željka Čučković, Marcela Blagaj, Vanja Lukšić, Ivica Peršec, Jasminka Šribar, Andrej |
author_facet | Ćurčić, Maja Tarle, Marko Almahariq, Hani Hleb, Sonja Havaš, Juraj Pražetina, Marko Lasić, Hrvoje Dolenc, Emil Kukoč, Andrea Mihelčić, Antonija Miko, Ivan Romić, Andrea Tipura, Danijela Drmić, Željka Čučković, Marcela Blagaj, Vanja Lukšić, Ivica Peršec, Jasminka Šribar, Andrej |
author_sort | Ćurčić, Maja |
collection | PubMed |
description | Background: Superinfections contribute to mortality and length of stay in critically ill COVID-19 patients. The aim of this study was to determine the incidence and pathogen distribution of bacterial and fungal superinfections of the lower respiratory tract (LRTI), urinary tract (UTI) and bloodstream (BSI) and to determine the predictive value of biomarkers of inflammatory response on their ICU survival rates. Methods: A retrospective observational study that included critically ill COVID-19 patients treated during an 11-month period in a Croatian national COVID-19 hospital was performed. Clinical and diagnostic data were analyzed according to the origin of superinfection, and multivariate regression analysis was performed to determine the predictive values of biomarkers of inflammation on their survival rates. Results: 55.3% critically ill COVID-19 patients developed bacterial or fungal superinfections, and LRTI were most common, followed by BSI and UTI. Multidrug-resistant pathogens were the most common causes of LRTI and BSI, while Enterococcus faecalis was the most common pathogen causing UTI. Serum ferritin and neutrophil count were associated with decreased chances of survival in patients with LRTI, and patients with multidrug-resistant isolates had significantly higher mortality rates, coupled with longer ICU stays. Conclusion: The incidence of superinfections in critically ill COVID-19 patients was 55.3%, and multidrug-resistant pathogens were dominant. Elevated ferritin levels and neutrophilia at ICU admission were associated with increased ICU mortality in patients with positive LRTI. |
format | Online Article Text |
id | pubmed-9497731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94977312022-09-23 Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia Ćurčić, Maja Tarle, Marko Almahariq, Hani Hleb, Sonja Havaš, Juraj Pražetina, Marko Lasić, Hrvoje Dolenc, Emil Kukoč, Andrea Mihelčić, Antonija Miko, Ivan Romić, Andrea Tipura, Danijela Drmić, Željka Čučković, Marcela Blagaj, Vanja Lukšić, Ivica Peršec, Jasminka Šribar, Andrej Diagnostics (Basel) Article Background: Superinfections contribute to mortality and length of stay in critically ill COVID-19 patients. The aim of this study was to determine the incidence and pathogen distribution of bacterial and fungal superinfections of the lower respiratory tract (LRTI), urinary tract (UTI) and bloodstream (BSI) and to determine the predictive value of biomarkers of inflammatory response on their ICU survival rates. Methods: A retrospective observational study that included critically ill COVID-19 patients treated during an 11-month period in a Croatian national COVID-19 hospital was performed. Clinical and diagnostic data were analyzed according to the origin of superinfection, and multivariate regression analysis was performed to determine the predictive values of biomarkers of inflammation on their survival rates. Results: 55.3% critically ill COVID-19 patients developed bacterial or fungal superinfections, and LRTI were most common, followed by BSI and UTI. Multidrug-resistant pathogens were the most common causes of LRTI and BSI, while Enterococcus faecalis was the most common pathogen causing UTI. Serum ferritin and neutrophil count were associated with decreased chances of survival in patients with LRTI, and patients with multidrug-resistant isolates had significantly higher mortality rates, coupled with longer ICU stays. Conclusion: The incidence of superinfections in critically ill COVID-19 patients was 55.3%, and multidrug-resistant pathogens were dominant. Elevated ferritin levels and neutrophilia at ICU admission were associated with increased ICU mortality in patients with positive LRTI. MDPI 2022-08-26 /pmc/articles/PMC9497731/ /pubmed/36140471 http://dx.doi.org/10.3390/diagnostics12092069 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ćurčić, Maja Tarle, Marko Almahariq, Hani Hleb, Sonja Havaš, Juraj Pražetina, Marko Lasić, Hrvoje Dolenc, Emil Kukoč, Andrea Mihelčić, Antonija Miko, Ivan Romić, Andrea Tipura, Danijela Drmić, Željka Čučković, Marcela Blagaj, Vanja Lukšić, Ivica Peršec, Jasminka Šribar, Andrej Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia |
title | Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia |
title_full | Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia |
title_fullStr | Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia |
title_full_unstemmed | Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia |
title_short | Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia |
title_sort | distribution of pathogens and predictive values of biomarkers of inflammatory response at icu admission on outcomes of critically ill covid-19 patients with bacterial superinfections—observations from national covid-19 hospital in croatia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497731/ https://www.ncbi.nlm.nih.gov/pubmed/36140471 http://dx.doi.org/10.3390/diagnostics12092069 |
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