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Author Spotlight: A Comprehensive Protocol for Acinetobacter Biofilm Quantification, Assessment, and Visualization
Published on: August 4, 2023
Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit
Alessandro Russo1,2, Francesca Gavaruzzi2, Giancarlo Ceccarelli2
1Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
Objectives:
Superinfections in patients hospitalized in intensive care unit (ICU) are an important and challenging complication, also in COVID-19. However, no definitive data are available about the role of multidrug-resistant Acinetobacter baumannii (MDR-AB) in COVID-19.
Methods:
This was a single-center, cross-sectional study including patients with MDR-AB infections admitted to ICU with or without COVID-19, between January 2019 and January 2021. The primary objective of the study was to evaluate risk factor for MDR-AB infections in ICU patients hospitalized for COVID-19 or other etiology. The secondary endpoints were 30-days mortality in all study population and risk factors associated with development of bloodstream infection (BSI).
Results:
During the study period 32 adults with COVID-19 were enrolled and compared with 115 patients admitted in the same ICU for other reasons. We observed a total of 114 deaths, with a survival rate of 29.3%: 18.8% in COVID-19 and 32.2% in control group. Relative risk for MDR-AB infection in COVID-19 showed that serum lactate levels mmol/l > 2, Acinetobacter baumannii colonization, BSI and steroid therapy were observed more frequently in COVID-19 patients. Cox regression analysis showed that serum lactate levels > 2 mmol/l, Acinetobacter baumannii colonization, BSI, and steroid therapy were associated with 30-days mortality. Finally, patients with COVID-19, white blood cells count > 11,000 mm3, serum lactate levels > 2 mmol/l, infections at time of ICU admission, Acinetobacter baumannii colonization, and steroid therapy were independently associated with development of BSI.
Conclusions:
Our data highlight the impact of BSI on outcome, the role of Acinetobacter baumannii colonization and the use of steroids on the risk to develop MDR-AB infections also during COVID-19.
Insights
Multidrug-resistant Acinetobacter baumannii (MDR-AB) infections pose a risk in intensive care units (ICUs), particularly for COVID-19 patients. Steroid therapy and Acinetobacter baumannii colonization are linked to increased MDR-AB infections and mortality.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Superinfections are a significant challenge in intensive care units (ICUs), including during COVID-19.
- Data on the specific role of multidrug-resistant Acinetobacter baumannii (MDR-AB) in COVID-19 patients are limited.
Purpose of the Study:
- To evaluate risk factors for MDR-AB infections in ICU patients with or without COVID-19.
- To assess 30-day mortality and identify risk factors for bloodstream infections (BSI) in this population.
Main Methods:
- A single-center, cross-sectional study involving ICU patients with MDR-AB infections from January 2019 to January 2021.
- Comparison of patients with COVID-19 against a control group admitted for other reasons.
- Analysis of risk factors for MDR-AB infection, 30-day mortality, and BSI development.
Main Results:
- COVID-19 patients showed higher frequencies of elevated serum lactate, Acinetobacter baumannii colonization, BSI, and steroid therapy.
- Serum lactate levels >2 mmol/l, Acinetobacter baumannii colonization, BSI, and steroid therapy were associated with 30-day mortality.
- Independent factors for BSI in COVID-19 patients included high white blood cell count, elevated serum lactate, prior infections, Acinetobacter baumannii colonization, and steroid therapy.
Conclusions:
- Bloodstream infections significantly impact patient outcomes in the ICU.
- Acinetobacter baumannii colonization and the use of steroids are identified as key factors increasing the risk of MDR-AB infections, even in the context of COVID-19.
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