Department of Clinical Laboratory, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China; The Third School of Clinical Medicine, Southern Medical University, Guangzhou, 510630, China.
Department of Clinical Laboratory, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China; The Third School of Clinical Medicine, Southern Medical University, Guangzhou, 510630, China.
J Glob Antimicrob Resist. 2024 Sep;38:6-11. doi: 10.1016/j.jgar.2024.04.007. Epub 2024 May 7.
This study aimed to analyse the bacterial composition, distribution, drug sensitivity, and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who develop bacterial co-infections.
We conducted a retrospective study of 184 patients with COVID-19 admitted between December 2022 and January 2023. Data on gender, age, length of hospital stay, pneumonia classification, underlying diseases, invasive surgery, hormone therapy, inflammation indicators, and other relevant information were collected. Samples of sputum, bronchoscopy sputum, alveolar lavage fluid, middle urine, puncture fluid, wound secretions, and blood were collected for pathogen isolation, identification, and drug sensitivity testing.
The majority of patients with COVID-19 with bacterial co-infection were elderly and had underlying diseases. Invasive surgery and hormone therapy were identified as risk factors for co-infections. Laboratory analysis showed reduced lymphocyte counts and elevated levels of C-reactive protein and procalcitonin. The most common pathogens in co-infections were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. The detection rate of drug-resistant strains, including methicillin-resistant S. aureus, carbapenem-resistant K. pneumoniae, carbapenem-resistant A. baumannii, carbapenem-resistant P. aeruginosa, and carbapenem-resistant E. coli, increased with the severity of pneumonia.
Respiratory tract infections were the most common site of bacterial co-infection in patients with COVID-19. Severe cases were more susceptible to multidrug-resistant pathogens, leading to a higher mortality rate. Timely control and prevention of co-infection are crucial for improving the prognosis of patients with COVID-19.
本研究旨在分析发生细菌合并感染的 2019 冠状病毒病（COVID-19）患者的细菌组成、分布、药敏情况和临床特征。
我们对 2022 年 12 月至 2023 年 1 月期间收治的 184 例 COVID-19 患者进行了回顾性研究。收集了患者的性别、年龄、住院时间、肺炎分类、基础疾病、有创手术、激素治疗、炎症指标等数据。采集痰、支气管镜下痰液、肺泡灌洗液、中段尿、穿刺液、伤口分泌物和血液样本进行病原体分离、鉴定和药敏试验。
COVID-19 合并细菌感染的患者多为老年人且有基础疾病。有创手术和激素治疗被确定为合并感染的危险因素。实验室分析显示淋巴细胞计数减少，C 反应蛋白和降钙素原水平升高。合并感染中最常见的病原体是金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌。耐甲氧西林金黄色葡萄球菌、碳青霉烯类耐药肺炎克雷伯菌、碳青霉烯类耐药鲍曼不动杆菌、碳青霉烯类耐药铜绿假单胞菌和碳青霉烯类耐药大肠埃希菌等耐药菌株的检出率随肺炎严重程度的增加而升高。
呼吸道感染是 COVID-19 患者细菌合并感染的最常见部位。重症患者更容易感染多药耐药病原体，导致死亡率更高。及时控制和预防合并感染对改善 COVID-19 患者的预后至关重要。
