1. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Member of Antimicrobial Stewardship Committee, Cipto Mangunkusumo Hospital, Jakarta, Indonesia..
Acta Med Indones. 2022 Apr;54(2):161-169.
Data on secondary bacterial infection in patients with COVID-19 in Indonesia are still limited, while the use of empirical antibiotics continues to increase. This study aims to determine the secondary bacterial infection rate in hospitalized COVID-19 patients and factors related to secondary bacterial infection.
This is a retrospective cohort study on hospitalized COVID-19 patients undergoing treatment at Cipto Mangunkusumo Hospital from March 2020 to September 2020. Secondary bacterial infection is defined as the identification of a bacterial pathogen from a microbiological examination.
From a total of 255 subjects, secondary infection was identified in 14.5%. Predictors of secondary infection were early symptoms of shortness of breath (OR 5.31, 95% CI 1.3 - 21.5), decreased consciousness (OR 4.81, 95% CI 1.77 - 13.0), length of stay > 12 days (OR 8.2, 95% CI 2.9 - 23.3), and central venous catheter placement (OR 3.0, 95% CI 1.1 - 8.0) The most common pathogen of secondary bacterial infection is Acinetobacter sp. (n=9; 28%). Empirical antibiotics were administered to 82.4% of subjects with predominant use of macrolides (n=141; 32.4%).
The secondary bacterial infection rate in COVID-19 was 14.5% and is associated with dyspnea, decreased consciousness, length of stay >12 days, and central venous catheter placement. The use of antibiotics in COVID-19 reaches 82.4% and requires special attention to prevent the occurrence of antibiotic resistance.
印度尼西亚关于 COVID-19 患者继发细菌感染的数据仍然有限，而经验性使用抗生素的情况仍在继续增加。本研究旨在确定住院 COVID-19 患者继发细菌感染的发生率以及与继发细菌感染相关的因素。
这是一项回顾性队列研究，纳入了 2020 年 3 月至 2020 年 9 月在 Cipto Mangunkusumo 医院接受治疗的住院 COVID-19 患者。继发细菌感染定义为从微生物检查中鉴定出细菌病原体。
在总共 255 名患者中，有 14.5%的患者发生了继发感染。继发感染的预测因素包括早期呼吸急促症状（OR 5.31，95%CI 1.3-21.5）、意识下降（OR 4.81，95%CI 1.77-13.0）、住院时间>12 天（OR 8.2，95%CI 2.9-23.3）和中央静脉置管（OR 3.0，95%CI 1.1-8.0）。继发细菌感染最常见的病原体是鲍曼不动杆菌（n=9；28%）。82.4%的患者使用了经验性抗生素，其中大环内酯类药物（n=141；32.4%）使用最多。
COVID-19 患者的继发细菌感染发生率为 14.5%，与呼吸困难、意识下降、住院时间>12 天和中央静脉置管有关。COVID-19 患者抗生素使用率达到 82.4%，需要特别注意防止抗生素耐药的发生。
