Rafat Zahra, Ramandi Alireza, Khaki Pegah Afarinesh, Ansari Saham, Ghaderkhani Sara, Haidar Hassan, Tajari Faezeh, Roostaei Davoud, Ghazvini Roshanak Daei, Hashemi Seyed Jamal, Abdollahi Alireza, Kamali Sarvestani Hasti
Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of General Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Gene Rep. 2022 Jun;27:101588. doi: 10.1016/j.genrep.2022.101588. Epub 2022 Mar 8.
The pandemic of COVID-19 has created a global public health crisis. ICU patients with COVID-19 are prone to infections of bacterial and/or fungal origins due to several risk factors. Consequently, the current study was conducted to evaluate the frequency, demographic characteristics, underlying conditions, and etiologic agents of fungal and bacterial co-infections of the respiratory tract among ICU patients with COVID-19 in Iran.
From May to October 2020, sputa and endotracheal aspirates were collected from ICU patients hospitalized with COVID-19 who also were suspected of bacterial and/or fungal co-infections according to inclusion criteria. The etiologic agents of bacterial co-infections were identified using the Vitek 2 identification method. For fungal identification, all samples were analyzed by direct microscopy using KOH 10% and culture. Furthermore, all isolates were subjected to sequencing method.
A total of 73 lung specimens were obtained from patients who met the inclusion criteria. Of these, in 15 cases (20.54%) fungal and/or bacterial co-infections were confirmed. Males were more infected (73.33%) and all of them were between 49 and 79 years. (n = 8, 61.53%) and (n = 5, 38.46%) were the most frequent etiologic agents related to fungal and bacterial co-infections, respectively. Pneumonia (n = 15, 100%) and diabetes mellitus (n = 8, 53.33%) were documented as the most prevalent underlying conditions. In the current study, 3 out of 15 patients (20%) died.
The frequency of bacterial co-infections of the respiratory tract in ICU patients hospitalized with COVID-19 was relatively high. According to the results, one of the causes of death of these patients could be a secondary infection.
新型冠状病毒肺炎（COVID-19）大流行引发了全球公共卫生危机。由于多种风险因素，COVID-19重症监护病房（ICU）患者易发生细菌和/或真菌源性感染。因此，本研究旨在评估伊朗COVID-19 ICU患者呼吸道真菌和细菌合并感染的频率、人口统计学特征、基础疾病及病原体。
2020年5月至10月，从因COVID-19住院且根据纳入标准怀疑有细菌和/或真菌合并感染的ICU患者中采集痰液和气管内吸出物。采用Vitek 2鉴定方法鉴定细菌合并感染的病原体。对于真菌鉴定，所有样本均采用10%氢氧化钾直接显微镜检查和培养进行分析。此外，所有分离株均采用测序方法。
共从符合纳入标准的患者中获得73份肺标本。其中，15例（20.54%）确诊为真菌和/或细菌合并感染。男性感染率更高（73.33%），所有患者年龄在49至79岁之间。分别为与真菌和细菌合并感染相关的最常见病原体。肺炎（n = 15，100%）和糖尿病（n = 8，53.33%）被记录为最常见的基础疾病。在本研究中，15例患者中有3例（20%）死亡。
因COVID-19住院的ICU患者呼吸道细菌合并感染频率相对较高。根据结果，这些患者死亡原因之一可能是继发感染。
