Related Experiment Video
Updated: Jul 26, 2025
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Coinfections in intensive care units. Has anything changed with Covid-19 pandemia?
Federica Romanelli1, Stefania Stolfa2, Luigi Ronga3
1a:1:{s:5:"en_US";s:115:"1Section of Microbiology, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy";}. federica.romanelli@policlinico.ba.it.
Insights
This study compared bacterial and fungal co-infections in COVID-19 patients to those in pre-pandemic intensive care unit (ICU) patients. Findings reveal specific pathogens like Acinetobacter baumannii are more prevalent in COVID-19 patients, guiding empirical therapy choices.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Critical Care Medicine
Background:
- The Coronavirus disease 2019 (COVID-19) pandemic has raised concerns about secondary bacterial and fungal infections.
- These co-infections can significantly increase disease severity and mortality in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
- Understanding changes in co-infection patterns is crucial for effective patient management and empirical treatment strategies.
Purpose of the Study:
- To evaluate the incidence and types of bacterial and fungal co-infections in COVID-19 patients admitted to the ICU.
- To compare these co-infection rates with those in patients admitted to the ICU during the pre-COVID-19 era.
- To determine if the pandemic has altered the prevalence of overinfections in ICU settings.
Main Methods:
- Analysis of clinical specimens (blood cultures, urine, tracheobronchial aspirates) from 1905 patients.
- Dedicated intensive care units (ICUs) were established for SARS-CoV-2 patients during the pandemic.
- Comparison of microbial isolate prevalence between COVID-19 patients and non-COVID-19 patients from the pre-COVID-19 era.
Main Results:
- Statistically significant differences in pathogen prevalence were observed between COVID-19 and non-COVID-19 patients.
- Specific pathogens like Acinetobacter baumannii complex, Aspergillus fumigatus, Escherichia coli, Haemophilus influenzae, and Serratia marcescens showed differing prevalence in respiratory samples.
- Candida albicans in urine, and Acinetobacter baumannii complex, Enterococcus faecalis, and Enterococcus faecium in blood cultures were also significantly different.
Conclusions:
- While isolated organisms are common in healthcare-associated infections, COVID-19 patients showed a particular prevalence of Acinetobacter baumannii, Stenotrophomonas maltophilia, and Aspergillus spp. in the respiratory tract.
- A significant increase in Candida albicans in urine samples was noted in COVID-19 patients.
- Bloodstream infections in COVID-19 patients were notably associated with Acinetobacter baumannii, Enterococcus faecalis, and Enterococcus faecium.
Background And Aim:
Since December 2019, the Coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2), has spread from China, becoming a pandemic. Bacterial and fungal co-infections may lead to increase in COVID-19 severity with a decrease in patients survive. The aim of this work was to evaluate bacterial and fungal co-infections in COVID-19 patients admitted to ICU in comparison with patients recovered in ICU in pre-COVID-19 era in order to understand whether the pandemic had changed the incidence of overinfections in patients admitted to ICU. In fact, the epidemiological data should guide the choice of empirical therapy.
Methods:
During pandemic, AOUC Policlinico of Bari organized dedicated ICUs for patient with SARS-CoV-2. Blood cultures, urine, and tracheobronchial aspirate were included in the analysis.
Results:
Specimens of 1905 patients were analysed in this work. Comparing clinical isolates prevalence by material and COVID-19 vs. non-COVID-19 patients statistically significant differences were detected for A. baumannii complex, Aspergillus fumigatus, Escherichia coli, Haemophilus influenzae and Serratia marcescens isolated from tracheobronchial aspirates; C. albicans from urine samples, A. baumannii complex, Enterococcus faecalis and Enterococcus faecium isolated from blood culture.
Conclusions:
Although the organisms isolated in COVID-19 patients are consistent with those frequently associated with healthcare associated infection, our data suggest a particular prevalence in COVID-19 patients of A. baumannii, Stenotrophomonas maltophilia and Aspergillus spp. in the respiratory tract, C. albicans in urine and A. baumannii, E. faecalis and E. faecium in blood cultures.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: