Bedenić Branka, Bratić Vesna, Mihaljević Slobodan, Lukić Anita, Vidović Karlo, Reiner Krešimir, Schöenthaler Silvia, Barišić Ivan, Zarfel Gernot, Grisold Andrea
Department for Microbiology and Parasitology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Clinical Department for Clinical and Molecular Microbiology, School of Medicine, University Hospital Center Zagreb, University of Zagreb, 10000 Zagreb, Croatia.
Pathogens. 2023 Jan 10;12(1):117. doi: 10.3390/pathogens12010117.
During November to December 2020, a high rate of COVID-19-associated pneumonia with bacterial superinfections due to multidrug-resistant (MDR) pathogens was recorded in a COVID-19 hospital in Zagreb. This study analyzed the causative agents of bacterial superinfections among patients with serious forms of COVID-19. In total, 118 patients were hospitalized in the intensive care unit (ICU) of the COVID-19 hospital. Forty-six out of 118 patients (39%) developed serious bacterial infection (VAP or BSI or both) during their stay in ICU. The total mortality rate was 83/118 (70%). The mortality rate due to bacterial infection or a combination of ARDS with bacterial superinfection was 33% (40/118). Six patients had MDR organisms and 34 had XDR (extensively drug-resistant). The dominant species was with all isolates (34) being carbapenem-resistant (CRAB) and positive for carbapenem-hydrolyzing oxacillinases (CHDL). One causing pneumonia harboured the gene. It appears that the dominant resistance determinants of causative agents depend on the local epidemiology in the particular COVID center. seems to easily spread in overcrowded ICUs. Croatia belongs to the 15 countries in the world with the highest mortality rate among COVID-19 patients, which could be in part attributable to the high prevalence of bacterial infections in local ICUs.
2020年11月至12月期间，萨格勒布一家新冠肺炎医院记录了因多重耐药（MDR）病原体导致的新冠肺炎相关肺炎合并细菌重叠感染的高发病率。本研究分析了重症新冠肺炎患者细菌重叠感染的病原体。共有118名患者入住该新冠肺炎医院的重症监护病房（ICU）。118名患者中有46名（39%）在ICU住院期间发生了严重细菌感染（呼吸机相关性肺炎或血流感染或两者兼有）。总死亡率为83/118（70%）。因细菌感染或急性呼吸窘迫综合征合并细菌重叠感染导致的死亡率为33%（40/118）。6名患者感染了多重耐药菌，34名患者感染了广泛耐药菌（XDR）。优势菌种为，所有分离株（34株）均对碳青霉烯类耐药（CRAB）且碳青霉烯水解型青霉素酶（CHDL）呈阳性。一株引起肺炎的菌株携带了基因。致病病原体的主要耐药决定因素似乎取决于特定新冠肺炎治疗中心的当地流行病学情况。似乎很容易在拥挤的ICU中传播。克罗地亚是世界上新冠肺炎患者死亡率最高的15个国家之一，这可能部分归因于当地ICU中细菌感染的高流行率。
