Pharmacy, Birzeit University, Ramallah, Palestine, 14, Palestinian Territory.
Department of Nursing, Birzeit University, Ramallah, Palestine, 14, Palestinian Territory.
F1000Res. 2022 Jan 11;11:30. doi: 10.12688/f1000research.74566.2. eCollection 2022.
Diagnosis of co-infections with multiple pathogens among hospitalized coronavirus disease 2019 (COVID-19) patients can be jointly challenging and essential for appropriate treatment, shortening hospital stays and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single center cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine. The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged ≥20 years, with a confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay conducted on a nasopharyngeal swab. The patient's information was gathered using graded data forms from electronic medical reports. The diagnosis of bacterial and fungal infection was proved through the patient's clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the intensive care unit (ICU) admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates ( species and ). The rate of fungal co-infection caused by was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental. Bacterial and fungal co-infection is common among COVID-19 patients at the ICU in Palestine, but it is not obvious if these cases are attributed to SARS-CoV-2 or coincidental, because little data is available to compare it with the rates of secondary infection in local ICU departments before the pandemic. Comprehensively, those conclusions present data supporting a conservative antibiotic administration for severely unwell COVID-19 infected patients. Our examination regarding the impacts of employing antifungals to manage COVID-19 patients can work as a successful reference for future COVID-19 therapy.
诊断 COVID-19 住院患者的多种病原体合并感染可能具有挑战性，且对于恰当的治疗、缩短住院时间和预防抗菌药物耐药至关重要。本研究旨在调查 COVID-19 患者细菌和真菌感染合并感染结局的负担。这是一项在巴勒斯坦拜特贾拉医院进行的 COVID-19 住院患者的单中心横断面研究。该研究纳入了 2020 年 6 月至 2021 年 3 月期间入住 ICU 的 321 名年龄≥20 岁的 COVID-19 确诊患者，通过对鼻咽拭子进行逆转录-聚合酶链反应检测来确诊 COVID-19。使用电子病历中的分级数据表单收集患者信息。通过患者的临床表现和血或痰培养阳性结果来证实细菌和真菌感染的诊断。所有患者在入住 ICU 前均接受了经验性抗菌治疗，在 ICU 期间采用了不同的治疗方案。细菌合并感染率为 51.1%，主要来源于革兰氏阴性菌（ 种和 ）。真菌感染由 引起的比例为 48.9%，死亡率为 8.1%。然而，尚不清楚这些病例是归因于 SARS-CoV-2 还是偶发。
在巴勒斯坦的 ICU 中，COVID-19 患者中细菌和真菌感染合并感染很常见，但尚不清楚这些病例是归因于 SARS-CoV-2 还是偶发，因为在大流行之前，几乎没有数据可以与当地 ICU 科室的继发感染率进行比较。总之，这些结论提供了数据支持对病情严重的 COVID-19 感染患者进行保守的抗生素治疗。我们对使用抗真菌药物治疗 COVID-19 患者的影响的检查可以为未来的 COVID-19 治疗提供成功的参考。
