Co-infection in critically ill patients with COVID-19: An observational cohort study from England
| Autor: | Louise Lansbury, Bethan Charles, Sarah Platt, Priya Daniel, Adam R Jeans, Paul Dark, Tom Williams, Peter R. Wilson, Jonathan D. Edgeworth, Hannah Lawrence, Sara E Boyd, Claire Phillips, Jayne Ellis, Shahideh Safavi, Martin J. Llewelyn, Andrew Barr, Lucy Venyo, Tricia M. McKeever, Wei Shen Lim, Martin Beed, Ethan Redmore, Tom Bewick, Karmel Webb, Charlotte Eggleston, Eve Hamilton, Jamie McCanny, Vadsala Baskaran, Clare Thakker, Tausif Huq, Matthias Schmid, Izzah Zainuddin |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) biology business.industry Klebsiella pneumoniae Critically ill Incidence (epidemiology) Retrospective cohort study biology.organism_classification medicine.disease_cause Intensive care Internal medicine Streptococcus pneumoniae Medicine business Cohort study |
| Popis: | ObjectiveTo describe the incidence and nature of co-infection in critically ill adults with COVID-19 infection in England.MethodsA retrospective cohort study of adults with COVID-19 admitted to seven intensive care units (ICUs) in England up to 18 May 2020, was performed. Patients with completed ICU stays were included. The proportion and type of organisms were determined at 48 hours following hospital admission, corresponding to community and hospital-acquired co-infections.ResultsOf 254 patients studied (median age 59 years (IQR 49-69); 64.6% male), 139 clinically significant organisms were identified from 83(32.7%) patients. Bacterial co-infections were identified within 48 hours of admission in 14(5.5%) patients; the commonest pathogens were Staphylococcus aureus (four patients) and Streptococcus pneumoniae (two patients). The proportion of pathogens detected increased with duration of ICU stay, consisting largely of Gram-negative bacteria, particularly Klebsiella pneumoniae and Escherichia coli. The co-infection rate >48 hours after admission was 27/1000 person-days (95% CI 21.3-34.1). Patients with co-infections were more likely to die in ICU (crude OR 1.78,95% CI 1.03-3.08, p=0.04) compared to those without co-infections.ConclusionWe found limited evidence for community-acquired bacterial co-infection in hospitalised adults with COVID-19, but a high rate of Gram-negative infection acquired during ICU stay. |
| Databáze: | OpenAIRE |
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