Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.
Ann Ist Super Sanita. 2020 Jul-Sep;56(3):359-364. doi: 10.4415/ANN_20_03_14.
Current literature shows that secondary bacterial infections, although less frequent than in previous influenza pandemics, affect COVID-19 patients. Mycoplasma pneumoniae, Staphylococcus aureus, Legionella pneumophila, Streptococcus pneumoniae, Haemophilus and Klebsiella spp. are the main species isolated. Of note, Mycobacterium tuberculosis-COVID-19 coinfections are also reported. However, bacterial coinfection rates increase in patients admitted in the intensive care units, and those diseases can be due to super-infections by nosocomial antibiotic-resistant bacteria. This highlights the urgency to revise frequent and empiric prescription of broad-spectrum antibiotics in COVID-19 patients, with more attention to evidence-based studies and respect for the antimicrobial stewardship principles.
目前的文献表明，继发性细菌感染虽然比以往的流感大流行时少见，但会影响 COVID-19 患者。肺炎支原体、金黄色葡萄球菌、嗜肺军团菌、肺炎链球菌、嗜血杆菌和克雷伯菌属等是主要分离的物种。值得注意的是，也有报道称结核分枝杆菌与 COVID-19 合并感染。然而，在重症监护病房住院的患者中，细菌合并感染的发生率增加，这些疾病可能是由于医院内抗生素耐药菌的超级感染引起的。这凸显了修订 COVID-19 患者频繁和经验性使用广谱抗生素的紧迫性，更加注重基于证据的研究并尊重抗菌药物管理原则。
