| Autor: |
Santus P; Division of Respiratory Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, 20147 Milano, Italy.; Coordinated Research Center on Respiratory Failure, University of Milan, 20122 Milano, Italy., Danzo F; Division of Respiratory Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, 20147 Milano, Italy., Signorello JC; Division of Respiratory Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, 20147 Milano, Italy., Rizzo A; Laboratory of Clinical Microbiology, Virology and Bioemergencies-ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, 20157 Milano, Italy., Gori A; Department of Infectious Diseases, L. Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20122 Milano, Italy.; Centre for Multidisciplinary Research in Health Science (MACH), Università Degli Studi di Milano, 20122 Milano, Italy., Antinori S; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milano, Italy., Gismondo MR; Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, 20157 Milano, Italy., Brambilla AM; Emergency Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milano, Italy., Contoli M; Respiratory Section, Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy., Rizzardini G; I Division of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milano, Italy., Radovanovic D; Division of Respiratory Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, 20147 Milano, Italy.; Coordinated Research Center on Respiratory Failure, University of Milan, 20122 Milano, Italy. |
| Abstrakt: |
Which patients should be monitored for coinfections or should receive empirical antibiotic treatment, in patients with an acute viral respiratory infection, is largely unknown. We evaluated the prevalence, characteristics, outcomes of coinfected patients, and risk factors associated with a coinfection among patients with an acute viral infection. A retrospective, single-center study recruited consecutive patients from October 2022 to March 2023 presenting to the emergency department with signs of a respiratory tract infection. Patients were screened for respiratory viruses and bacterial/fungal secondary infections according to local standard procedures. Outcomes included severe disease, in-hospital complications, all-cause in-hospital and ICU-related mortality, time to death, time to discharge, and time to coinfection. The analysis included 652 patients. A viral infection and a secondary bacterial/fungal infection were detected in 39.1% and 40% of cases. Compared with the rest of the cohort, coinfected patients had more frequently severe disease (88.3%, p < 0.001; 51% in patients with SARS-CoV-2) and higher in-hospital mortality (16.5%, p = 0.010). Nephropathy (OR 3.649, p = 0.007), absence of COVID-19 vaccination (OR 0.160, p < 0.001), SARS-CoV-2 infection (OR 2.390, p = 0.017), and lower blood pressure at admission (OR 0.980, p = 0.007) were independent risk factors for coinfection. Multidrug-resistant pathogens were detected in 30.8% of all coinfections. Patients with a viral infection are at high risk of bacterial coinfections, which carry a significant morbidity and mortality burden. |
