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Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter

Hyo-Ju Son1, Tark Kim2, Eunjung Lee3

  • 1Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

American Journal of Infection Control
|June 19, 2021
PubMed
Abstract

Insights

Multi-drug resistant organism (MDRO) co-infections in severe COVID-19 patients are linked to higher mortality. Previous long-term care facility stays and corticosteroid use are key risk factors for MDRO isolation.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Severe coronavirus disease 2019 (COVID-19) patients face risks from co-infections with multi-drug resistant organisms (MDROs).
  • Identifying MDRO risk factors is crucial for improving outcomes in COVID-19 patients, even with stringent precautions.

Purpose of the Study:

  • To evaluate the epidemiology of MDRO isolation in hospitalized COVID-19 pneumonia patients.
  • To identify risk factors associated with MDRO isolation in this patient population.

Main Methods:

  • Retrospective analysis of 152 adult COVID-19 pneumonia patients from 10 hospitals in South Korea (February-May 2020).
  • Focus on 47 patients with available microbial culture results to assess MDRO prevalence and characteristics.
  • Statistical analysis to identify risk factors for MDRO isolation.

Main Results:

  • MDROs were isolated from 28% of patients with culture data (13/47), with Stenotrophomonas maltophilia and MRSA being most common.
  • MDROs were primarily isolated from sputum samples, with a median isolation time of 28 days post-hospitalization.
  • In-hospital mortality was significantly higher in patients with MDRO isolation (62% vs. 15%, P=.001).

Conclusions:

  • MDRO isolation occurred in 28% of cultured COVID-19 patients, significantly increasing mortality risk.
  • Pre-existing long-term care facility (LTCF) residency and the use of systemic corticosteroids post-COVID-19 diagnosis were identified as significant risk factors for MDRO isolation.
  • Enhanced infection prevention strategies are recommended for COVID-19 patients with identified risk factors.
Keywords:
Antimicrobial resistanceCOVID-19CorticosteroidsLong-term care facilitySARS-CoV-2

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