Risk Factors for Multi-Drug Resistance (MDR) Infections in COVID-19 Patients with Secondary Bacterial Infections

The COVID-19 pandemic has significantly affected global health, contributing to an increase in secondary bacterial infections caused by multidrug-resistant (MDR) pathogens, thereby increasing morbidity and mortality. This study aims to evaluate the risk factors of MDR bacterial infections in affected COVID-19 patients.

This retrospective cohort study analyzed medical records, as well as clinical and epidemiological data of COVID-19 patients with secondary bacterial infections hospitalized in Cipto Mangunkusumo General Hospital during 2020 - 2021. During the procedures, only patients with positive microbial culture results were included. Bivariate and multivariate analyses were carried out to evaluate risk factors of MDR bacterial infections.

A total of 3203 medical records of COVID-19 patients were assessed, and 192 subjects were enrolled. The results showed that the most common secondary infection and pathogen were pneumonia and Acinetobacter baumanii, respectively. In addition, the most common MDR pathogen was A.baumanii. In the multivariate log-binomial analysis, the risk factors associated with MDR bacterial infections in COVID-19 were female gender (RR 1,194;CI95% 1,024 - 1,393 p 0,020), comorbidity (RR 1,181;CI95% 1,006 - 1,385, p 0,041), prior antibiotic use (RR 1.718; CI95% 1,127 - 2,620 p 0,012), and history of invasive procedure (RR 1,979;CI95% 1,423 - 2.753 p <0,001).

Comorbidities, female gender, prior antibiotic use, and a history of invasive procedures were risk factors for secondary bacterial infections with an MDR pathogen in hospitalized COVID-19 patients.