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Staphylococcus aureus Bacteremia in Patients Infected With COVID-19: A Case Series
Jaclyn A Cusumano1,2, Amy C Dupper3,4, Yesha Malik3,4
1Mount Sinai Queens, Queens, New York, USA.
Background:
Previous viral pandemics have shown that secondary bacterial infections result in higher morbidity and mortality, with Staphylococcus aureus being the primary causative pathogen. The impact of secondary S. aureus bacteremia on mortality in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown.
Methods:
This was a retrospective observational case series of patients with coronavirus disease 2019 (COVID-19) who developed secondary S. aureus bacteremia across 2 New York City hospitals. The primary end point was to describe 14-day and 30-day hospital mortality rates of patients with COVID-19 and S. aureus bacteremia. Secondary end points included predictors of 14-day and 30-day hospital mortality in patients with COVID-19 and S. aureus bacteremia.
Results:
A total of 42 patients hospitalized for COVID-19 with secondary S. aureus bacteremia were identified. Of these patients, 23 (54.8%) and 28 (66.7%) died at 14 days and 30 days, respectively, from their first positive blood culture. Multivariate analysis identified hospital-onset bacteremia (≥4 days from date of admission) and age as significant predictors of 14-day hospital mortality and Pitt bacteremia score as a significant predictor of 30-day hospital mortality (odds ratio [OR], 11.9; 95% CI, 2.03-114.7; P = .01; OR, 1.10; 95% CI, 1.03-1.20; P = .02; and OR, 1.56; 95% CI, 1.19-2.18; P = .003, respectively).
Conclusions:
Bacteremia with S. aureus is associated with high mortality rates in patients hospitalized with COVID-19. Further investigation is warranted to understand the impact of COVID-19 and secondary S. aureus bacteremia.
Insights
Secondary Staphylococcus aureus (S. aureus) bacteremia significantly increases mortality in hospitalized COVID-19 patients. This study highlights high 14-day and 30-day death rates, emphasizing the need for further research into this dangerous complication.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Secondary bacterial infections, particularly Staphylococcus aureus (S. aureus), are known to increase morbidity and mortality during viral pandemics.
- The specific impact of S. aureus bacteremia on mortality in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was previously unknown.
Purpose of the Study:
- To describe the 14-day and 30-day hospital mortality rates for patients with coronavirus disease 2019 (COVID-19) who developed secondary S. aureus bacteremia.
- To identify predictors of mortality in this patient population.
Main Methods:
- A retrospective observational case series was conducted across two New York City hospitals.
- Data were collected on 42 hospitalized patients with COVID-19 who developed secondary S. aureus bacteremia.
- Multivariate analysis was used to determine predictors of 14-day and 30-day mortality.
Main Results:
- A high mortality rate was observed: 54.8% died by 14 days and 66.7% by 30 days after the first positive blood culture.
- Hospital-onset bacteremia (≥4 days from admission) and patient age were significant predictors of 14-day mortality.
- Pitt bacteremia score predicted 30-day mortality (OR, 1.56; P = .003).
Conclusions:
- Staphylococcus aureus bacteremia is associated with substantial mortality in patients hospitalized with COVID-19.
- Further research is needed to fully understand the interplay between COVID-19 and secondary S. aureus infections.
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