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Streptococcus pneumoniae Coinfection in COVID-19: A Series of Three Cases
Chaitanya Pal1, Paulina Przydzial1, Ogechukwu Chika-Nwosuh2
1Department of Medicine, Newark Beth Israel Medical Center, New Jersey 07112, USA.
Abstract:
Bacterial coinfections are not uncommon with respiratory viral pathogens. These coinfections can add to significant mortality and morbidity. We are currently dealing with the SARS-CoV-2 pandemic, which has affected over 15 million people globally with over half a million deaths. Previous respiratory viral pandemics have taught us that bacterial coinfections can lead to higher mortality and morbidity. However, there is limited literature on the current SARS-CoV-2 pandemic and associated coinfections, which reported infection rates varying between 1% and 8% based on various cross-sectional studies. In one meta-analysis of coinfections in COVID-19, rates of Streptococcus pneumoniae coinfections have been negligible when compared to previous influenza pandemics. Current literature does not favor the use of empiric, broad-spectrum antibiotics in confirmed SARS-CoV-2 infections. We present three cases of confirmed SARS-CoV-2 infections complicated by Streptococcus pneumoniae coinfection. These cases demonstrate the importance of concomitant testing for common pathogens despite the need for antimicrobial stewardship.
Insights
Bacterial coinfections, like Streptococcus pneumoniae, can complicate SARS-CoV-2 infections, increasing mortality. Early pathogen testing is crucial for effective treatment, even with antimicrobial stewardship concerns.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Bacterial coinfections frequently accompany respiratory viral illnesses, escalating mortality and morbidity.
- The SARS-CoV-2 pandemic presents a significant global health crisis, with limited data on coinfection rates.
- Previous pandemics highlight the severe impact of bacterial coinfections alongside viral outbreaks.
Observation:
- Current literature indicates variable SARS-CoV-2 coinfection rates (1-8%) and suggests low rates of Streptococcus pneumoniae coinfection compared to influenza.
- Despite this, three cases of SARS-CoV-2 infection complicated by Streptococcus pneumoniae coinfection were identified.
- These cases underscore the potential for significant bacterial coinfections in COVID-19 patients.
Findings:
- The presented cases highlight the occurrence of Streptococcus pneumoniae coinfection in patients with confirmed SARS-CoV-2.
- This challenges the notion of negligible bacterial coinfection rates in the current pandemic.
- Concomitant testing for common bacterial pathogens is essential for accurate diagnosis and treatment.
Implications:
- These findings emphasize the need for vigilant diagnostic testing for bacterial coinfections in SARS-CoV-2 patients.
- It supports the judicious use of antibiotics based on confirmed infections rather than empiric broad-spectrum use.
- This approach is vital for optimizing patient outcomes and promoting antimicrobial stewardship.
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