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2019冠状病毒病患者入住二级护理医院后发生继发性细菌感染的发生率及院内死亡的危险因素:一项单中心横断面回顾性研究。

Incidence of secondary bacterial infections and risk factors for in-hospital mortality among coronavirus disease 2019 subjects admitted to secondary care hospital: A single-center cross-sectional retrospective study.

作者信息

Sannathimmappa Mohan Bilikallahalli, Marimuthu Yamini, Al Subhi Shayma Mohsin Mohammed Said, Al Bathari Faiza Awaidhan Mohammed Bakhit, Al Balushi Mariya Ibrahim Ahmed, Al Ghammari Sara Ibrahim Rashid, Al-Risi Elham Said, Al-Maqbali Salima, Nambiar Vinod, Al-Shafaee Mohammad

机构信息

Department of Microbiology and Immunology, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman.

Department of Community Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.

出版信息

Int J Crit Illn Inj Sci. 2024 Apr-Jun;14(2):94-100. doi: 10.4103/ijciis.ijciis_71_23. Epub 2024 Jun 21.

Abstract

BACKGROUND

This study aims to determine the prevalence of secondary bacterial infections (SBIs) in hospitalized coronavirus disease 2019 (COVID-19) subjects and evaluate their antibiotic susceptibility. The study also sought to identify risk factors for the outcome of SBIs in COVID-19 subjects.

METHODS

This single-center cross-sectional retrospective study was carried out at Sohar Hospital in Oman. The study examined hospitalized COVID-19 subjects diagnosed with SBIs during March 2020-December 2022. The relevant subjects' data were extracted from hospital electronic health records and analyzed using STATA version 14. The Chi-square test or Fisher's exact test was employed for analyzing categorical variables, and < 0.05 was deemed statistically significant.

RESULTS

The research encompassed a total of 817 bacteria recovered from various clinical samples of 421 subjects. The older individuals (39.4%) and men (65.6%) experienced bacterial infections more frequently, with bloodstream and respiratory infections being the most common. Gram-negative bacilli (GNB) were responsible for a higher proportion (85.6%) of infections, with , , and being the most common pathogens. Subjects who underwent mechanical ventilation, received corticosteroid therapy, and who had underlying comorbidities, such as diabetes and chronic renal disease, were found to have higher mortality rates. Neutrophilia, elevated C-reactive protein, lymphocytopenia, decreased serum albumin level, sepsis, and pneumonia were found to be independent contributors to mortality.

CONCLUSIONS

SBI is common among COVID-19-hospitalized subjects. GNB were primarily linked to SBI. The severity and the likelihood of SBI increased in subjects undergoing medical interventions and immunosuppressive therapy.

摘要

背景

本研究旨在确定2019冠状病毒病(COVID-19)住院患者中继发性细菌感染(SBI)的患病率,并评估其抗生素敏感性。该研究还试图确定COVID-19患者发生SBI的危险因素。

方法

这项单中心横断面回顾性研究在阿曼苏哈尔医院进行。该研究检查了2020年3月至2022年12月期间被诊断为SBI的COVID-19住院患者。从医院电子健康记录中提取相关患者数据,并使用STATA 14版进行分析。采用卡方检验或Fisher精确检验分析分类变量,P<0.05被认为具有统计学意义。

结果

该研究共从421名患者的各种临床样本中分离出817株细菌。年龄较大的个体(39.4%)和男性(65.6%)细菌感染更为频繁,血流感染和呼吸道感染最为常见。革兰氏阴性杆菌(GNB)导致的感染比例更高(85.6%),其中大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌是最常见的病原体。接受机械通气、接受皮质类固醇治疗以及患有糖尿病和慢性肾病等基础合并症的患者死亡率较高。中性粒细胞增多、C反应蛋白升高、淋巴细胞减少、血清白蛋白水平降低、脓毒症和肺炎被发现是死亡率的独立影响因素。

结论

SBI在COVID-19住院患者中很常见。GNB主要与SBI有关。接受医疗干预和免疫抑制治疗的患者SBI的严重程度和可能性增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05ee/11245142/0b7bc36d1513/IJCIIS-14-94-g001.jpg

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