Department of Infectious Diseases and Clinical Microbiology, American Hospital, Istanbul, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Koc University School of Medicine, Istanbul, Turkey.
Sci Rep. 2023 Aug 16;13(1):13345. doi: 10.1038/s41598-023-39632-2.
We described the secondary bacterial infections (SBI) among COVID-19 patients in comparison with non-COVID-19 patients. We performed a retrospective case-control study between January 01, 2020 and April 01, 2022. Including the adult patients, who stayed ≥ 72 h in intensive care unit (ICU). In total 405 patients were included, 135 had (33.3%) COVID-19, with similar age and gender. The length of stay in ICU was not different (11.4 vs 8.2, p = 0.109), however mean intubation days were higher among COVID-19 cases (6.5 vs 3.8, p = 0.005), SBI were more common among COVID-19 cases (34% vs 10.7%, p < 0.001). Among the patients with pneumonia, the rate of gram-positive bacteria was higher in COVID-19 group than the control group (39% vs 5%, p = 0.006). The predictors for SBI were having COVID-19 (OR: 2.3, Cl 1.25-4.32, p = 0.008), days of intubation (OR: 1.05, Cl 1.01-1.10, p = 0.004), and being male (OR: 2, Cl 1.12-3.58, p = 0.018). The predictors of mortality were COVID-19 (OR: 2.38, Cl 1.28-4.42, p = 0.006), days of intubation (OR: 1.06, Cl 1.03-1.09, p < 0.001), active hematologic malignancy (OR: 3.1, Cl: 1.33-7.28, p = 0.09), active solid tumors (OR: 2.44, Cl 1.21-4.91, p = 0.012), and coronary artery diseases (OR: 1.8, Cl 1.01-3.52, p = 0.045). The most common SBI in COVID-19 patients were methicillin-sensitive Staphylococcus aureus. No carbapenem-resistant Enterobacterales related infections were detected in COVID-19 patients.
我们比较了 COVID-19 患者和非 COVID-19 患者的继发性细菌感染 (SBI)。我们进行了一项回顾性病例对照研究，时间范围为 2020 年 1 月 1 日至 2022 年 4 月 1 日。纳入标准为在重症监护病房 (ICU) 中住院时间≥72 小时的成年患者。共纳入 405 例患者，其中 135 例 (33.3%)COVID-19 患者，两组患者年龄和性别相似。COVID-19 患者 ICU 住院时间无差异 (11.4 天 vs 8.2 天，p=0.109)，但 COVID-19 患者的气管插管天数更高 (6.5 天 vs 3.8 天，p=0.005)，SBI 更为常见 (34% vs 10.7%，p<0.001)。在肺炎患者中，COVID-19 组革兰阳性菌的发生率高于对照组 (39% vs 5%，p=0.006)。SBI 的预测因素包括 COVID-19 (OR：2.3，Cl 1.25-4.32，p=0.008)、气管插管天数 (OR：1.05，Cl 1.01-1.10，p=0.004) 和男性 (OR：2，Cl 1.12-3.58，p=0.018)。死亡率的预测因素包括 COVID-19 (OR：2.38，Cl 1.28-4.42，p=0.006)、气管插管天数 (OR：1.06，Cl 1.03-1.09，p<0.001)、活动性血液恶性肿瘤 (OR：3.1，Cl：1.33-7.28，p=0.009)、活动性实体肿瘤 (OR：2.44，Cl 1.21-4.91，p=0.012) 和冠状动脉疾病 (OR：1.8，Cl 1.01-3.52，p=0.045)。COVID-19 患者中最常见的 SBI 是耐甲氧西林金黄色葡萄球菌。未检测到 COVID-19 患者与碳青霉烯类耐药肠杆菌科相关的感染。
