Department of Internal Medicine, AMITA Health Saint Francis Hospital, Evanston, IL, USA.
Critical Care Units, AMITA Health Saint Francis Hospital, Evanston, IL, USA.
Med Sci Monit. 2020 Nov 14;26:e928754. doi: 10.12659/MSM.928754.
BACKGROUND A lethal synergism between the influenza virus and Streptococcus pneumoniae has been identified. However, bacterial coinfection is considered relatively infrequent in hospitalized patients with COVID-19, and the co-prevalence of Streptococcus pneumoniae is low. MATERIAL AND METHODS We retrospectively analyzed the clinical characteristics and outcomes of patients subsequently admitted to AMITA Health Saint Francis Hospital between March 1 and June 30, 2020, with documented SARS-CoV-2 and S. pneumoniae coinfection. RESULTS We identified 11 patients with S. pneumoniae coinfection. The median age was 77 years (interquartile range [IQR], 74-82 years), 45.5% (5/11) were males, 54.5% (6/11) were white, and 90.9% (10/11) were long-term care facility (LTCF) residents. The median length of stay was 7 days (IQR, 6-8 days). Among 11 patients, 4 were discharged in stable condition and 7 had died, resulting in an inpatient mortality rate of 64%. CONCLUSIONS At our center, 11 patients with COVID-19 pneumonia who had confirmed infection with SARS-CoV-2 were diagnosed with Streptococcus pneumoniae infection while in hospital. All patients had pneumonia confirmed on imaging and a nonspecific increase in markers of inflammation. The in-hospital mortality rate of 64% (7 patients) was higher in this group than in previous reports. This study highlights the importance of monitoring bacterial coinfection in patients with viral lung infection due to SARS-CoV-2.
已确定流感病毒和肺炎链球菌之间存在致命协同作用。然而，在 COVID-19 住院患者中，细菌合并感染被认为相对较少，肺炎链球菌的合并感染率较低。
我们回顾性分析了 2020 年 3 月 1 日至 6 月 30 日期间因 COVID-19 入住 AMITA 健康圣弗朗西斯医院并确诊同时感染 SARS-CoV-2 和肺炎链球菌的患者的临床特征和结局。
我们共发现 11 例肺炎链球菌合并感染患者。中位年龄为 77 岁（四分位距[IQR]，74-82 岁），45.5%（5/11）为男性，54.5%（6/11）为白人，90.9%（10/11）为长期护理机构（LTCF）居民。中位住院时间为 7 天（IQR，6-8 天）。11 例患者中，4 例出院时病情稳定，7 例死亡，住院病死率为 64%。
在我们中心，11 例确诊感染 SARS-CoV-2 的 COVID-19 肺炎患者在住院期间被诊断为肺炎链球菌感染。所有患者的影像学均证实有肺炎，炎症标志物均有非特异性升高。该组住院病死率（7 例患者）为 64%，高于以往报告。本研究强调了由于 SARS-CoV-2 引起的病毒性肺部感染患者中监测细菌合并感染的重要性。
