Bergmann Felix, Gabler Cornelia, Nussbaumer-Pröll Alina, Wölfl-Duchek Michael, Blaschke Amelie, Radtke Christine, Zeitlinger Markus, Jorda Anselm
Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria.
Crit Care Explor. 2023 Apr 10;5(4):e0895. doi: 10.1097/CCE.0000000000000895. eCollection 2023 Apr.
Previous findings suggest that bacterial coinfections are less common in ICU patients with COVID-19 than with influenza, but evidence is limited.
This study aimed to compare the rate of early bacterial coinfections in ICU patients with COVID-19 or influenza.
Retrospective propensity score matched cohort study. We included patients admitted to ICUs of a single academic center with COVID-19 or influenza (January 2015 to April 2022).
The primary outcome was early bacterial coinfection (i.e., positive blood or respiratory culture within 2 d of ICU admission) in the propensity score matched cohort. Key secondary outcomes included frequency of early microbiological testing, antibiotic use, and 30-day all-cause mortality.
Out of 289 patients with COVID-19 and 39 patients with influenza, 117 ( = 78 vs 39) were included in the matched analysis. In the matched cohort, the rate of early bacterial coinfections was similar between COVID-19 and influenza (18/78 [23%] vs 8/39 [21%]; odds ratio, 1.16; 95% CI, 0.42-3.45; = 0.82). The frequency of early microbiological testing and antibiotic use was similar between the two groups. Within the overall COVID-19 group, early bacterial coinfections were associated with a statistically significant increase in 30-day all-cause mortality (21/68 [30.9%] vs 40/221 [18.1%]; hazard ratio, 1.84; 95% CI, 1.01-3.32).
Our data suggest similar rates of early bacterial coinfections in ICU patients with COVID-19 and influenza. In addition, early bacterial coinfections were significantly associated with an increased 30-day mortality in patients with COVID-19.
先前的研究结果表明，与流感患者相比，新冠病毒病（COVID-19）重症监护病房（ICU）患者的细菌合并感染较少见，但证据有限。
本研究旨在比较COVID-19或流感ICU患者早期细菌合并感染的发生率。
设计、地点和参与者：回顾性倾向评分匹配队列研究。我们纳入了2015年1月至2022年4月期间在单一学术中心ICU住院的COVID-19或流感患者。
主要结局是倾向评分匹配队列中的早期细菌合并感染（即ICU入院后2天内血液或呼吸道培养阳性）。关键次要结局包括早期微生物检测频率、抗生素使用情况和30天全因死亡率。
在289例COVID-19患者和39例流感患者中，117例（COVID-19组78例，流感组39例）纳入匹配分析。在匹配队列中，COVID-19和流感患者早期细菌合并感染的发生率相似（18/78 [23%] 对比8/39 [21%]；优势比为1.16；95%置信区间为0.42 - 3.45；P = 0.82）。两组早期微生物检测频率和抗生素使用情况相似。在整个COVID-19组中，早期细菌合并感染与30天全因死亡率在统计学上显著增加相关（21/68 [30.9%] 对比40/221 [18.1%]；风险比为1.84；95%置信区间为1.01 - 3.32）。
我们的数据表明，COVID-19和流感ICU患者早期细菌合并感染的发生率相似。此外，早期细菌合并感染与COVID-19患者30天死亡率增加显著相关。
