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2020 年哥伦比亚麦德林两家诊所收治的 COVID-19 成年住院患者中的细菌合并感染。

Bacterial superinfection in adults with COVID-19 hospitalized in two clinics in Medellín-Colombia, 2020.

机构信息

Universidad de Antioquia, Medellín, Colombia.

Clínica CES, Medellín, Colombia.

出版信息

PLoS One. 2021 Jul 13;16(7):e0254671. doi: 10.1371/journal.pone.0254671. eCollection 2021.

Abstract

COVID-19 represents high morbidity and mortality, its complications and lethality have increased due to bacterial superinfections. We aimed to determine the prevalence of bacterial superinfection in adults with COVID-19, hospitalized in two clinics in Medellín-Colombia during 2020, and its distribution according to sociodemographic and clinical conditions. A cross sectional study was made with 399 patients diagnosed with COVID-19 by RT-PCR. We determined the prevalence of bacterial superinfection and its factors associated with crude and adjusted prevalence ratios by a generalized linear model. The prevalence of superinfection was 49.6%, with 16 agents identified, the most frequent were Klebsiella (pneumoniae and oxytoca) and Staphylococcus aureus. In the multivariate adjustment, the variables with the strongest association with bacterial superinfection were lung disease, encephalopathy, mechanical ventilation, hospital stay, and steroid treatment. A high prevalence of bacterial superinfections, a high number of agents, and multiple associated factors were found. Among these stood out comorbidities, complications, days of hospitalization, mechanical ventilation, and steroid treatment. These results are vital to identifying priority clinical groups, improving the care of simultaneous infections with COVID-19 in people with the risk factors exposed in the population studied, and identifying bacteria of public health interest.

摘要

COVID-19 代表着高发病率和死亡率,由于细菌的继发感染,其并发症和致死率有所增加。我们旨在确定 2020 年在哥伦比亚麦德林的两家诊所住院的 COVID-19 成年患者中细菌继发感染的患病率,并根据社会人口统计学和临床状况进行分布。这是一项横断面研究,共纳入了 399 例经 RT-PCR 诊断为 COVID-19 的患者。我们通过广义线性模型确定了细菌继发感染的患病率及其与粗比和调整后比相关的因素。继发感染的患病率为 49.6%,共鉴定出 16 种病原体,最常见的病原体是肺炎克雷伯菌(肺炎和产酸克雷伯菌)和金黄色葡萄球菌。在多变量调整中,与细菌继发感染关联最强的变量是肺部疾病、脑病、机械通气、住院时间和类固醇治疗。发现存在高继发感染率、高数量的病原体和多种相关因素。在这些因素中,突出的是合并症、并发症、住院天数、机械通气和类固醇治疗。这些结果对于确定优先临床群体、改善对研究人群中暴露的危险因素的 COVID-19 合并感染的护理以及识别具有公共卫生意义的细菌至关重要。

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