Department of Microbiology, All India Institute of Medical Sciencesgrid.413618.9, New Delhi, India.
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciencesgrid.413618.9, New Delhi, India.
Microbiol Spectr. 2021 Sep 3;9(1):e0016321. doi: 10.1128/Spectrum.00163-21. Epub 2021 Jul 21.
Emerging evidence indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals are at an increased risk for coinfections; therefore, physicians need to be cognizant about excluding other treatable respiratory pathogens. Here, we report coinfection with SARS-CoV-2 and other respiratory pathogens in patients admitted to the coronavirus disease (COVID) care facilities of an Indian tertiary care hospital. From June 2020 through January 2021, we tested 191 patients with SARS-CoV-2 for 33 other respiratory pathogens using an fast track diagnostics respiratory pathogen 33 (FTD-33) assay. Additionally, information regarding other relevant respiratory pathogens was collected by reviewing their laboratory data. Overall, 13 pathogens were identified among patients infected with SARS-CoV-2, and 46.6% (89/191) of patients had coinfection with one or more additional pathogens. Bacterial coinfections (41.4% [79/191]) were frequent, with Staphylococcus aureus being the most common, followed by Klebsiella pneumoniae. Coinfections with SARS-CoV-2 and Pneumocystis jirovecii or Legionella pneumophila were also identified. The viral coinfection rate was 7.3%, with human adenovirus and human rhinovirus being the most common. Five patients in our cohort had positive cultures for Acinetobacter baumannii and K. pneumoniae, and two patients had active Mycobacterium tuberculosis infection. In total, 47.1% (90/191) of patients with coinfections were identified. The higher proportion of patients with coinfections in our cohort supports the systemic use of antibiotics in patients with severe SARS-CoV-2 pneumonia with rapid de-escalation based on respiratory PCR/culture results. The timely and simultaneous identification of coinfections can contribute to improved health of COVID-19 patients and enhanced antibiotic stewardship during the pandemic. Coinfections in COVID-19 patients may worsen disease outcomes and need further investigation. We found that a higher proportion of patients with COVID-19 were coinfected with one or more additional pathogens. A better understanding of the prevalence of coinfection with other respiratory pathogens in COVID-19 patients and the profile of pathogens can contribute to effective patient management and antibiotic stewardship during the current pandemic.
越来越多的证据表明，严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染个体发生合并感染的风险增加；因此，医生需要注意排除其他可治疗的呼吸道病原体。在这里，我们报告了在印度一家三级护理医院的冠状病毒疾病（COVID）治疗设施中住院的 SARS-CoV-2 感染患者合并感染其他呼吸道病原体的情况。从 2020 年 6 月至 2021 年 1 月，我们使用快速诊断呼吸道病原体 33（FTD-33）检测试剂盒对 191 例 SARS-CoV-2 患者进行了 33 种其他呼吸道病原体的检测。此外，通过回顾实验室数据收集了有关其他相关呼吸道病原体的信息。总体而言，在感染 SARS-CoV-2 的患者中发现了 13 种病原体，46.6%（89/191）的患者合并感染了一种或多种其他病原体。细菌合并感染（41.4%[79/191]）很常见，最常见的是金黄色葡萄球菌，其次是肺炎克雷伯菌。还发现了 SARS-CoV-2 与卡氏肺孢子虫或嗜肺军团菌的合并感染。病毒合并感染率为 7.3%，最常见的是人腺病毒和人鼻病毒。我们的队列中有 5 名患者的鲍曼不动杆菌和肺炎克雷伯菌培养阳性，2 名患者有活动性结核分枝杆菌感染。共有 47.1%（90/191）的合并感染患者被确定。我们的队列中合并感染患者的比例较高支持在严重 SARS-CoV-2 肺炎患者中系统使用抗生素，并根据呼吸道 PCR/培养结果进行快速降级。及时和同时识别合并感染可以改善 COVID-19 患者的健康状况，并在大流行期间加强抗生素管理。COVID-19 患者的合并感染可能会使病情恶化，需要进一步研究。我们发现，更高比例的 COVID-19 患者合并感染了一种或多种其他病原体。更好地了解 COVID-19 患者中其他呼吸道病原体合并感染的流行情况和病原体特征可以有助于在当前大流行期间对患者进行有效管理和抗生素管理。
