Cusumano Jaclyn A, Dupper Amy C, Malik Yesha, Gavioli Elizabeth M, Banga Jaspreet, Berbel Caban Ana, Nadkarni Devika, Obla Ajay, Vasa Chirag V, Mazo Dana, Altman Deena R
Mount Sinai Queens, Queens, New York, USA.
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, New York, USA.
Open Forum Infect Dis. 2020 Nov 12;7(11):ofaa518. doi: 10.1093/ofid/ofaa518. eCollection 2020 Nov.
Previous viral pandemics have shown that secondary bacterial infections result in higher morbidity and mortality, with being the primary causative pathogen. The impact of secondary bacteremia on mortality in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown.
This was a retrospective observational case series of patients with coronavirus disease 2019 (COVID-19) who developed secondary bacteremia across 2 New York City hospitals. The primary end point was to describe 14-day and 30-day hospital mortality rates of patients with COVID-19 and bacteremia. Secondary end points included predictors of 14-day and 30-day hospital mortality in patients with COVID-19 and bacteremia.
A total of 42 patients hospitalized for COVID-19 with secondary bacteremia were identified. Of these patients, 23 (54.8%) and 28 (66.7%) died at 14 days and 30 days, respectively, from their first positive blood culture. Multivariate analysis identified hospital-onset bacteremia (≥4 days from date of admission) and age as significant predictors of 14-day hospital mortality and Pitt bacteremia score as a significant predictor of 30-day hospital mortality (odds ratio [OR], 11.9; 95% CI, 2.03-114.7; = .01; OR, 1.10; 95% CI, 1.03-1.20; = .02; and OR, 1.56; 95% CI, 1.19-2.18; = .003, respectively).
Bacteremia with is associated with high mortality rates in patients hospitalized with COVID-19. Further investigation is warranted to understand the impact of COVID-19 and secondary bacteremia.
既往病毒性大流行表明，继发性细菌感染会导致更高的发病率和死亡率，其中[细菌名称]是主要致病病原体。继发性[细菌名称]菌血症对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者死亡率的影响尚不清楚。
这是一项针对纽约市两家医院中发生继发性[细菌名称]菌血症的2019冠状病毒病（COVID-19）患者的回顾性观察病例系列研究。主要终点是描述COVID-19合并[细菌名称]菌血症患者的14天和30天医院死亡率。次要终点包括COVID-19合并[细菌名称]菌血症患者14天和30天医院死亡率的预测因素。
共确定了42例因COVID-19住院且发生继发性[细菌名称]菌血症的患者。在这些患者中，自首次血培养阳性起，分别有2于14天和30天死亡，其中23例（54.8%）在14天死亡，28例（66.7%）在30天死亡。多因素分析确定医院获得性菌血症（入院日期起≥4天）和年龄是14天医院死亡率的显著预测因素，而皮特菌血症评分是则是30天医院死亡率的显著预测因素（比值比[OR]分别为11.9；95%置信区间[CI]为2.03 - 114.7；P = 0.01；OR为1.10；95% CI为1.03 - 1.20；P = 0.02；以及OR为1.56；95% CI为1.19 - 2.18；P = 0.003）。
[细菌名称]菌血症与COVID-19住院患者的高死亡率相关。有必要进一步研究以了解COVID-19和继发性[细菌名称]菌血症的影响。
