MULTI-RESSISTRY BACTERIAL CO-INFECTIONS AND ANTIBIOTIC PRESCRIPTION PRACTICE IN ADULTS WITH COVID-19: A CASE CONTROL STUDY

Authors

DOI:

https://doi.org/10.47820/recima21.v3i8.1814

Keywords:

COVID-19, Multi-resistance, Antibiotics

Abstract

The emerging situation in health services caused by coronavirus has resulted in a strenuous increase in ICU admissions, as well as the use of antimicrobials, often indicated for treatment of co-infections acquired in the hospital environment. The present study aims to describe the factors associated with bacterial co-infections with a multidrug resistance (MR) profile compared to patients without a multidrug resistance profile. For this purpose, a case-control study was conducted containing 127 patients who were hospitalized with a diagnosis of COVID-19 and admitted to the Intensive Care Unit (ICU) of the reference hospital for the 8th Health Regional of Francisco Beltrão-PR, Brazil, with laboratory and clinical evidence of coinfection. The mean age was 55.22 years, ranging from 24 to 86 years, 85% of patients were admitted in the year 2021, 52.8% were male, stayed an average of 17.72 days in the ICU and 79.5% had at least one comorbidity, especially obesity, diabetes and hypertension. Of 66.1% COVID-19 patients who died, 52.4% had at least one multidrug-resistant bacteria (MR) coinfection. Patients with MR had a greater number of comorbidities, stayed more days in the ICU, used antimicrobials longer, and ventilator-associated pneumonia was variably associated with the presence of MR in patients with COVID-19.

Downloads

Download data is not yet available.

Author Biographies

Isadora Schwaab Guerini

Universidade Estadual do Oeste do Paraná

Maria Helena Brandeleiro Werlang

Universidade Estadual do Oeste do Paraná

Guilherme Welter Wendt

Universidade Estadual do Oeste do Paraná

Kerley Braga Pereira Bento Casaril

Universidade Estadual do Oeste do Paraná

Lirane Elize Defante Ferreto

Universidade Estadual do Oeste do Paraná

References

Farfour E, Lecuru M, Dortet L, Le Guen M, Cerf C, Karnycheff F, et al. Carbapenemase- producing Enterobacterales outbreak: Another dark side of COVID-19. Am J Infect Control. dezembro de 2020;48(12):1533–6.

Cantón R, Gijón D, Ruiz-Garbajosa P. Antimicrobial resistance in ICUs: an update in the light of the COVID-19 pandemic. Curr Opin Crit Care. outubro de 2020;26(5):433–41.

Cultrera R, Barozzi A, Libanore M, Marangoni E, Pora R, Quarta B, et al. Co-Infections in Critically Ill Patients with or without COVID-19: A Comparison of Clinical Microbial Culture Findings. Int J Environ Res Public Health. 20 de abril de 2021;18(8):4358.

Feldman C, Anderson R. The role of co-infections and secondary infections in patients with COVID-19. Pneumonia (Nathan). 25 de abril de 2021;13(1):5.

Langford BJ, So M, Raybardhan S, Leung V, Soucy J-PR, Westwood D, et al. Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clin Microbiol Infect. abril de 2021;27(4):520–31.

Bentivegna E, Luciani M, Arcari L, Santino I, Simmaco M, Martelletti P. Reduction of Multidrug-Resistant (MDR) Bacterial Infections during the COVID-19 Pandemic: A Retrospective Study. Int J Environ Res Public Health. 23 de janeiro de 2021;18(3):1003.

Marra AR, Camargo LFA, Pignatari ACC, Sukiennik T, Behar PRP, Medeiros EAS, et al. Nosocomial Bloodstream Infections in Brazilian Hospitals: Analysis of 2,563 Cases from a Prospective Nationwide Surveillance Study▿. J Clin Microbiol. maio de 2011;49(5):1866–71.

Graves N. Economics and Preventing Hospital-acquired Infection. Emerg Infect Dis. abril de 2004;10(4):561–6.

Razzaque MS. Exacerbation of antimicrobial resistance: another casualty of the COVID-19 pandemic? Expert Rev Anti Infect Ther. agosto de 2021;19(8):967–71.

Rawson TM, Moore LSP, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, et al. Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing. Clin Infect Dis. 3 de dezembro de 2020;71(9):2459–68.

Cheng LS, Chau SK, Tso EY, Tsang SW, Li IY, Wong BK, et al. Bacterial co-infections and antibiotic prescribing practice in adults with COVID-19: experience from a single hospital cluster. Therapeutic Advances in Infection. 1o de janeiro de 2020;7:2049936120978095.

Knight GM, Glover RE, McQuaid CF, Olaru ID, Gallandat K, Leclerc QJ, et al. Antimicrobial resistance and COVID-19: Intersections and implications. Cooper VS, Perry GH, organizadores. eLife. 16 de fevereiro de 2021;10:e64139.

Getahun H, Smith I, Trivedi K, Paulin S, Balkhy HH. Tackling antimicrobial resistance in the COVID-19 pandemic. Bull World Health Organ. 1o de julho de 2020;98(7):442-442ª.

Ramadan HK-A, Mahmoud MA, Aburahma MZ, Elkhawaga AA, El-Mokhtar MA, Sayed IM, et al. Predictors of Severity and Co-Infection Resistance Profile in COVID-19 Patients: First Report from Upper Egypt. Infect Drug Resist. 2020;13:3409–22.

Diaz E, Lorente L, Valles J, Rello J. [Mechanical ventilation associated pneumonia]. Med Intensiva. 1o de junho de 2010;34(5):318–24

Bardi T, Pintado V, Gomez-Rojo M, Escudero-Sanchez R, Azzam Lopez A, Diez-Remesal Y, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis. março de 2021;40(3):495–502.

Contou D, Claudinon A, Pajot O, Micaëlo M, Longuet Flandre P, Dubert M, et al. Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU. Ann Intensive Care. 7 de setembro de 2020;10(1):119.

Bogossian EG, Taccone FS, Izzi A, Yin N, Garufi A, Hublet S, et al. The Acquisition of Multidrug-Resistant Bacteria in Patients Admitted to COVID-19 Intensive Care Units: A Monocentric Retrospective Case Control Study. Microorganisms. 19 de novembro de 2020;8(11):E1821.

Vaughn VM, Gandhi TN, Petty LA, Patel PK, Prescott HC, Malani AN, et al. Empiric Antibacterial Therapy and Community-onset Bacterial Coinfection in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19): A Multi-hospital Cohort Study. Clin Infect Dis. 18 de maio de 2021;72(10):e533–41.

Cole J, Barnard E. The impact of the COVID-19 pandemic on healthcare acquired infections with multidrug resistant organisms. Am J Infect Control. maio de 2021;49(5):653–4.

Cano-Martín E, Portillo-Calderón I, Pérez-Palacios P, Navarro-Marí JM, Fernández-Sierra MA, Gutiérrez-Fernández J. A Study in a Regional Hospital of a Mid-Sized Spanish City Indicates a Major Increase in Infection/Colonization by Carbapenem-Resistant Bacteria, Coinciding with the COVID-19 Pandemic. Antibiotics (Basel). 18 de setembro de 2021;10(9):1127.

Bardi T, Pintado V, Gomez-Rojo M, Escudero-Sanchez R, Azzam Lopez A, Diez-Remesal Y, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis. março de 2021;40(3):495–502.

Wang L, Amin AK, Khanna P, Aali A, McGregor A, Bassett P, et al. An observational cohort study of bacterial co-infection and implications for empirical antibiotic therapy in patients presenting with COVID-19 to hospitals in North West London. Journal of Antimicrobial Chemotherapy. 1o de março de 2021;76(3):796–803.

Feldman C, Anderson R. The role of co-infections and secondary infections in patients with COVID-19. Pneumonia (Nathan). 25 de abril de 2021;13(1):5.

Bogossian EG, Taccone FS, Izzi A, Yin N, Garufi A, Hublet S, et al. The Acquisition of Multidrug-Resistant Bacteria in Patients Admitted to COVID-19 Intensive Care Units: A Monocentric Retrospective Case Control Study. Microorganisms. 19 de novembro de 2020;8(11):E1821.

Secretaria de Estado da Saúde do Paraná (SESA).Resolução 096/2018.

Published

27/08/2022

How to Cite

Schwaab Guerini, I. ., Brandeleiro Werlang, M. H. ., Welter Wendt, G. ., Braga Pereira Bento Casaril, K. ., & Defante Ferreto, L. E. . (2022). MULTI-RESSISTRY BACTERIAL CO-INFECTIONS AND ANTIBIOTIC PRESCRIPTION PRACTICE IN ADULTS WITH COVID-19: A CASE CONTROL STUDY. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 3(8), e381814. https://doi.org/10.47820/recima21.v3i8.1814