Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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
_version_ 1784794578763644928
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
work_keys_str_mv AT curcicmaja distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT tarlemarko distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT almahariqhani distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT hlebsonja distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT havasjuraj distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT prazetinamarko distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT lasichrvoje distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT dolencemil distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT kukocandrea distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT mihelcicantonija distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT mikoivan distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT romicandrea distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT tipuradanijela distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT drmiczeljka distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT cuckovicmarcela distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT blagajvanja distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT luksicivica distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT persecjasminka distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia
AT sribarandrej distributionofpathogensandpredictivevaluesofbiomarkersofinflammatoryresponseaticuadmissiononoutcomesofcriticallyillcovid19patientswithbacterialsuperinfectionsobservationsfromnationalcovid19hospitalincroatia