Diagnostic significance of secondary bacteremia in patients with COVID-19

OBJECTIVES: We investigated the occurrence of non-respiratory bacterial and fungal secondary infections, causative organisms, impact on clinical outcomes, and association between the secondary pathogens and mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: This wa...

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Detalles Bibliográficos
Autores principales: Nakagawara, Kensuke, Kamata, Hirofumi, Chubachi, Shotaro, Namkoong, Ho, Tanaka, Hiromu, Lee, Ho, Otake, Shiro, Fukushima, Takahiro, Kusumoto, Tatsuya, Morita, Atsuho, Azekawa, Shuhei, Watase, Mayuko, Asakura, Takanori, Masaki, Katsunori, Ishii, Makoto, Endo, Akifumi, Koike, Ryuji, Ishikura, Hiroyasu, Takata, Tohru, Matsushita, Yasushi, Harada, Norihiro, Kokutou, Hiroyuki, Yoshiyama, Takashi, Kataoka, Kensuke, Mutoh, Yoshikazu, Miyawaki, Masayoshi, Ueda, Soichiro, Ono, Hiroshi, Ono, Takuya, Shoko, Tomohisa, Muranaka, Hiroyuki, Kawamura, Kodai, Mori, Nobuaki, Mochimaru, Takao, Fukui, Mototaka, Chihara, Yusuke, Nagasaki, Yoji, Okamoto, Masaki, Amishima, Masaru, Odani, Toshio, Tani, Mayuko, Nishi, Koichi, Shirai, Yuya, Edahiro, Ryuya, Ando, Akira, Hashimoto, Naozumi, Ogura, Shinji, Kitagawa, Yuichiro, Kita, Toshiyuki, Kagaya, Takashi, Kimura, Yasuhiro, Miyazawa, Naoki, Tsuchida, Tomoya, Fujitani, Shigeki, Murakami, Koji, Sano, Hirohito, Sato, Yuki, Tanino, Yoshinori, Otsuki, Ryo, Mashimo, Shuko, Kuramochi, Mizuki, Hosoda, Yasuo, Hasegawa, Yoshinori, Ueda, Tetsuya, Takaku, Yotaro, Ishiguro, Takashi, Fujiwara, Akiko, Kuwahara, Naota, Kitamura, Hideya, Hagiwara, Eri, Nakamori, Yasushi, Saito, Fukuki, Kono, Yuta, Abe, Shinji, Ishii, Tomoo, Ohba, Takehiko, Kusaka, Yu, Watanabe, Hiroko, Masuda, Makoto, Watanabe, Hiroki, Kimizuka, Yoshifumi, Kawana, Akihiko, Kasamatsu, Yu, Hashimoto, Satoru, Okada, Yukinori, Takano, Tomomi, Katayama, Kazuhiko, Ai, Masumi, Kumanogoh, Atsushi, Sato, Toshiro, Tokunaga, Katsushi, Imoto, Seiya, Kitagawa, Yuko, Kimura, Akinori, Miyano, Satoru, Hasegawa, Naoki, Ogawa, Seishi, Kanai, Takanori, Fukunaga, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. 2023
Materias:
Note
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851919/
https://www.ncbi.nlm.nih.gov/pubmed/36682606
http://dx.doi.org/10.1016/j.jiac.2023.01.006
Descripción
Sumario:OBJECTIVES: We investigated the occurrence of non-respiratory bacterial and fungal secondary infections, causative organisms, impact on clinical outcomes, and association between the secondary pathogens and mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: This was a retrospective cohort study that included data from inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021). We obtained demographic, epidemiological, and microbiological data throughout the course of hospitalization and analyzed the cases of COVID-19 complicated by non-respiratory bacterial infections. RESULTS: Of the 1914 patients included, non-respiratory bacterial infections with COVID-19 were diagnosed in 81 patients (4.2%). Of these, 59 (3.1%) were secondary infections. Bacteremia was the most frequent bacterial infection, occurring in 33 cases (55.9%), followed by urinary tract infections in 16 cases (27.1%). Staphylococcus epidermidis was the most common causative organism of bacteremia. Patients with COVID-19 with non-respiratory secondary bacterial infections had significantly higher mortality, and a multivariate logistic regression analysis demonstrated that those with bacteremia (aOdds Ratio = 15.3 [5.97–39.1]) were at higher risk of death. Multivariate logistic regression analysis showed that age, male sex, use of steroids to treat COVID-19, and intensive care unit admission increased the risk for nosocomial bacteremia. CONCLUSIONS: Secondary bacteremia is an important complication that may lead to poor prognosis in cases with COVID-19. An appropriate medical management strategy must be established, especially for patients with concomitant predisposing factors.

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