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Investigating the Prevalence of Bacterial Infections in Patients with Coronavirus Disease 2019 Hospitalized in
Somaye Shiralizadeh1, Masoud Azimzadeh1, Fariba Keramat2,3
1Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran.
Background:
COVID-19 patient hospitalization, particularly in intensive care units, exposes them to bacterial and fungi co-infections, which can have very serious consequences, including increased mortality. In addition, antibiotic resistance among pathogens is a hidden threat behind COVID-19.
Methods:
In the period from 2020 September to 2021 August, bacterial isolates from COVID- 19 patients admitted to the ICU of Sina Hospital in Hamadan, Iran, were collected and identified based on standard biochemical tests. COVID-19 cases were confirmed based on clinical symptoms, computed tomography, and polymerase chain reaction. Antimicrobial susceptibility tests were conducted using disc diffusion and broth microdilution methods.
Results:
In total, 207 bacterial isolates were collected, with Klebsiella pneumoniae accounting for 69 (33.33%) and Acinetobacter baumannii accounting for 59 (28.15%). The frequency and percentage of isolated bacteria were as follows: Alcaligenes species 28 (13.59%), Staphylococcus aureus 18 (8.73%), Pseudomonas aeruginosa 15 (7.28%), Escherichia coli 11 (5.33%), Stenotrophomonas maltophilia 3 (1.45%), Enterococcus species 3 (1.45%), and Serratia species 1 (0.48%). About 95.38% resistance to ceftazidime and cefotaxime and 92.31% resistance to ciprofloxacin and cefepime were found in K. pneumoniae isolates. A. baumannii isolates were 100% resistant to cefotaxime, ceftriaxone, and cefepime. About 22.22% resistance to vancomycin and 66.67% resistance to clindamycin, erythromycin, and cefoxitin were seen in S. aureus isolates.
Conclusion:
Knowledge of bacterial co-infections and their antibiotic resistance pattern in COVID-19 patients can help in choosing effective antibiotics for the treatment and prevention of antibiotic resistance.
Insights
Bacterial co-infections in COVID-19 patients are common, with Klebsiella pneumoniae and Acinetobacter baumannii being prevalent. High antibiotic resistance rates were observed, highlighting the need for targeted treatment strategies.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Hospitalized COVID-19 patients, especially in ICUs, face risks of bacterial and fungal co-infections.
- These co-infections can lead to severe outcomes, including increased mortality.
- Antibiotic resistance poses a significant, often overlooked, threat in the context of COVID-19.
Purpose of the Study:
- To investigate the prevalence of bacterial co-infections in intensive care unit (ICU) patients with COVID-19.
- To identify common bacterial pathogens and determine their antimicrobial susceptibility patterns.
- To inform treatment strategies and combat rising antibiotic resistance.
Main Methods:
- Bacterial isolates were collected from COVID-19 ICU patients between September 2020 and August 2021.
- Patient COVID-19 status was confirmed using clinical symptoms, CT scans, and PCR.
- Standard biochemical tests identified bacteria, while antimicrobial susceptibility was assessed via disc diffusion and broth microdilution.
Main Results:
- A total of 207 bacterial isolates were identified. Klebsiella pneumoniae (33.33%) and Acinetobacter baumannii (28.15%) were the most frequent.
- High resistance rates were noted: K. pneumoniae showed ~95% resistance to ceftazidime/cefotaxime and ~92% to ciprofloxacin/cefepime.
- A. baumannii isolates exhibited 100% resistance to cefotaxime, ceftriaxone, and cefepime. Staphylococcus aureus displayed resistance to vancomycin (22.22%) and other antibiotics.
Conclusions:
- Understanding bacterial co-infections and resistance patterns in COVID-19 patients is crucial.
- This knowledge aids in selecting effective antibiotic treatments.
- Proactive management can help prevent the further spread of antibiotic resistance.
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