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Secondary infections in COVID-19: Antemortem and postmortem culture study
Vandana V Kiro1, Meenakshi Sharma2, Sharad Srivastava3
1Department of Microbiology, Division of Forensic Pathology and Molecular DNA, New Delhi, India.
Background:
Secondary bacterial infections during COVID-19 hospitalization have been reported in about 6-15% of patients.
Aims:
To study the secondary bacterial infections that affected the COVID-19 patients during their hospitalisation and to unearth the bacteriological profile of samples obtained after their demise.
Settings And Design:
This prospective study was carried out at a COVID-19 dedicated, apex tertiary care centre in North India from July 2020 to April 2021.
Methods And Materials:
Samples of 268 patients were considered for the study. Nasopharyngeal swab specimen, blood, and tissue (lung) were collected from the deceased body as early as possible and processed.
Statistical Analysis:
Statistical analyses were performed using STATA version 11.1 (Stata Corp., College Station, TX, USA).
Results:
A total of 170 samples were received from patients before their death, which included blood, urine, respiratory samples, pus, and cerebrospinal fluid. Forty-four pathogens were isolated, which consisted of Acinetobacter baumannii (43.1%), Klebsiella pneumoniae (36.3%), Escherichia coli (11.3%), and Pseudomonas aeruginosa (4.5%), Enterococcus faecium (4.5%). Two hundred fifty-eight samples were collected from the deceased bodies wherein the nasopharyngeal sample was highest, followed by tissue and blood. A total of 43 pathogens were isolated among them which included A. baumannii (44.1%), followed by K. pneumoniae (25.5%), E. coli (20.9%), P. aeruginosa (6.97%) and Enterobacter cloacae (2.3%). All these isolates were highly resistant to antimicrobials.
Conclusions:
In our study, bacterial profiles in antemortem and postmortem samples were found to be similar, suggesting that resistant pathogens may be the cause of mortality in COVID-19 infected hospitalised patients.
Insights
Secondary bacterial infections in hospitalized COVID-19 patients were studied. Resistant pathogens like Acinetobacter baumannii and Klebsiella pneumoniae were identified in both living and deceased patients, suggesting a role in mortality.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Secondary bacterial infections complicate COVID-19 hospitalizations in 6-15% of patients.
- Understanding these infections is crucial for patient outcomes.
Purpose of the Study:
- To investigate secondary bacterial infections in hospitalized COVID-19 patients.
- To determine the bacteriological profile of samples from deceased COVID-19 patients.
Main Methods:
- Prospective study conducted at a tertiary care center in North India (July 2020 - April 2021).
- Analysis of 268 patient samples (antemortem and postmortem), including nasopharyngeal swabs, blood, tissue, urine, and cerebrospinal fluid.
Main Results:
- Identified common pathogens: Acinetobacter baumannii (43.1% antemortem, 44.1% postmortem), Klebsiella pneumoniae (36.3% antemortem, 25.5% postmortem), and Escherichia coli (11.3% antemortem, 20.9% postmortem).
- All isolated pathogens exhibited high antimicrobial resistance.
- Bacterial profiles were similar in antemortem and postmortem samples.
Conclusions:
- Similar bacterial profiles in antemortem and postmortem samples suggest a link between resistant pathogens and COVID-19 mortality.
- Highlights the significant burden of antimicrobial-resistant infections in severe COVID-19 cases.
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