Bacterial superinfection and antibiotic management in patients with COVID-19 admitted to intensive care medicine in central Iran: A follow-up study

Nokhodian, Zary; Rostami, Soodabeh; Zeraatei, Parisa; Rahimkhorasani, Marzieh; Abbasi, Saeed; Sadeghi, Somayeh

Bacterial superinfection and antibiotic management in patients with COVID-19 admitted to intensive care medicine in central Iran: A follow-up study

Authors

¹ Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

² Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

³ Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

⁴ Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Bacterial superinfections are one of the crucial challenges in patients with coronavirus disease 2019 (COVID-19) that are associated with a high mortality rate. The current study was designed to assess bacterial superinfections and antibiotic management in COVID-19 patients admitted to intensive care unit (ICU).
Material and Methods: Seventy-three adult intubated patients with COVID-19 were included in a cross-sectional study. The lung aspirate samples were collected in two stages and assessed for bacterial growth by standard methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method as recommended by the Clinical Laboratory Standard Institute guideline (2021 edition). Also, demographic and clinical data were collected. The statistical analysis was done by chisquare test and Student's t-test, and a P value <0.05 was considered significant.
Results: Forty men and thirty-three women with a mean age of 64.78 ± 13.90 have included in our study. The mean length of hospitalization and stay in ICU were 18.77 ± 12.94 and 13.51 ± 9.83 days, respectively; 84.9% of cases died. Thirty-three patients had a bacterial superinfection mainly caused by Klebsiella spp and Acinetobacter spp; 21.2% of piperacillin/tazobactam consumers' patients survived that; the differences were significant (p = 0.034). A significant relationship was seen between superinfection and length of hospital stay until intubation (p = 0.033).
Conclusion: Bacterial superinfection and mortality rates were relatively high in COVID-19 patients admitted to ICU. According to the results, using beta-lactam/beta-lactamase inhibitors antibiotics in hospitalized patients in ICU can effectively control superinfection.

Keywords

References

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