Bacterial/fungal infection in hospitalized patients with COVID-19 in a tertiary hospital in the Community of Castilla y León, Spain.

Autor: Nebreda-Mayoral T; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: tnebreda@saludcastillayleon.es., Miguel-Gómez MA; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España., March-Rosselló GA; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España., Puente-Fuertes L; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España., Cantón-Benito E; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España., Martínez-García AM; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España., Muñoz-Martín AB; Servicio de Farmacia, Hospital Clínico Universitario de Valladolid, Valladolid, España., Orduña-Domingo A; Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Enfermedades infecciosas y microbiologia clinica (English ed.) [Enferm Infecc Microbiol Clin (Engl Ed)] 2020 Dec 03. Date of Electronic Publication: 2020 Dec 03.
DOI: 10.1016/j.eimc.2020.11.003
Abstrakt: Introduction: Bacterial/fungal coinfection and superinfections contribute to the increased morbi-mortality of viral respiratory infections (RIs). The main objective of this study was to determine the incidence of these infections in hospitalized patients with COVID-19.
Method: Retrospective observational study of all patients admitted for COVID-19 and bacterial/fungal infections at the Hospital Clínico Universitario of Valladolid, Spain (March 1-May 31, 2020). Demographic, clinical and microbiological data were compared based on Intensive Care Unit (ICU) admission and predictors of mortality by were identified using multivariate logistic regression analyses.
Results: Of the 712 COVID-19 patients, 113 (16%) presented bacterial/fungal coinfections or superinfections. Their median age was 73 years (IQR 57-89) and 59% were men. The profiles of ICU patients (44%) included male, SARS-CoV-2 pneumonia, leukocytosis, elevated inteleukin-6, with interferon β-1b and tocilizumab and superinfection (p < 0.05). Coinfections were diagnosed in 5% (39/712) patients. Most common pathogens of respiratory coinfection (18) were Streptococcus pneumoniae (6) and Staphylococcus aureus (6). Superinfections were detected in 11% (80/712) patients. Urinary (53) and RIs (39) constituted the majority of superinfections Acinetobacter baumannii multidrug-resistant was the main agent of IR and bacteremia. An outbreak of A. baumannii contributed to this result. Three patients were considered to have probable pulmonary aspergillosis. Mortality was higher in UCI patients (50 vs. 29%; p = 0.028). The predictive factors of mortality included being a male with various comorbidities, SARS-CoV-2 pneumonia, bacteremia and superinfections from A. baumannii.
Conclusion: The outbreak of A. baumannii was a determining factor in the increases of the incidence of infection and the morbi-mortality of ICU patients.
(Copyright © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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