Gomez Andrea C, Ortiz Tamin, Valenzuela Angélica, Egoávil-Espejo Rocío, Huerto-Huanuco Rosario, Pinto Joseph A, Lagos Jose, Ruiz Joaquim
Centro de Investigación Básica y Translacional, AUNA IDEAS, Lima, Peru.
Servicio de Microbiología y Biología Molecular, Laboratorios AUNA, Lima, Peru.
Front Mol Biosci. 2023 Mar 13;10:1113969. doi: 10.3389/fmolb.2023.1113969. eCollection 2023.
This study aimed to describe the clinical characteristics of patients with COVID-19 co-infected with multiple multidrug-resistant bacteria. Patients hospitalized in the AUNA network between January and May 2021, diagnosed with COVID-19 and at least two other infecting microorganisms, were retrospectively included in the analysis. Clinical and epidemiological data were extracted from clinical records. The susceptibility levels of the microorganisms were determined using automated methods. Antibiotic resistance was established among infecting bacteria accounting for ≥5 isolates. A total of 27 patients (21 male and 6 female patients) met the inclusion criteria, with a maximum of eight co-infecting bacteria or fungi during admission time. Seven patients (25.9%) died, with a higher but not significant lethality among women (50% vs. 19.0%). A total of 15 patients presented at least one established comorbidity, with hypertension being the most frequent. The time elapsed between COVID-19 diagnosis and hospital attendance was 7.0 days, with that of patients with a fatal outcome being longer than that of living patients (10.6 vs. 5.4). Up to 20 different microorganisms were isolated, with being the most common (34 isolates). In general, antibiotic resistance levels were high, especially in isolates, with resistance levels of 88.9% to all antimicrobial agents tested, except colistin (0%). In conclusion, the present results show the presence of multiple microorganisms that co-infect COVID-19 patients. When fatal outcome rates are in the range of other reports, the presence of a series of multidrug-resistant microorganisms is of concern, showing the need to reinforce control measures to limit the expansion of almost untreatable microorganisms.
本研究旨在描述新型冠状病毒肺炎（COVID-19）合并多种多重耐药菌感染患者的临床特征。回顾性纳入2021年1月至5月在AUNA网络住院、诊断为COVID-19且至少合并另外两种感染性微生物的患者进行分析。从临床记录中提取临床和流行病学数据。使用自动化方法测定微生物的药敏水平。在感染细菌中，若分离株≥5株，则确定其抗生素耐药情况。共有27例患者（21例男性和6例女性）符合纳入标准，住院期间最多合并8种细菌或真菌感染。7例患者（25.9%）死亡，女性致死率较高但差异无统计学意义（50%对19.0%）。共有15例患者至少有一种已确诊的合并症，其中高血压最为常见。COVID-19诊断至入院的时间为7.0天，死亡患者的该时间长于存活患者（10.6天对5.4天）。共分离出多达20种不同微生物， 最为常见（34株）。总体而言，抗生素耐药水平较高，尤其是 分离株，对除黏菌素（0%）外的所有测试抗菌药物耐药水平达88.9%。总之，目前结果显示COVID-19患者存在多种微生物合并感染。当病死率处于其他报告范围内时，一系列多重耐药微生物的存在令人担忧，这表明需要加强控制措施以限制几乎无法治疗的微生物的传播。
