Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis

Clinical Microbiology and Infection, Journal Year: 2021, Volume and Issue: 27(4), P. 520 - 531

Published: Jan. 9, 2021

Language: Английский

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Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: A systematic review and meta-analysis

PLoS ONE, Journal Year: 2021, Volume and Issue: 16(5), P. e0251170 - e0251170

Published: May 6, 2021

The recovery of other pathogens in patients with SARS-CoV-2 infection has been reported, either at the time a diagnosis (co-infection) or subsequently (superinfection). However, data on prevalence, microbiology, and outcomes co-infection superinfection are limited. purpose this study was to examine occurrence co-infections superinfections their among infection.

Language: Английский

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Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU

BMC Infectious Diseases, Journal Year: 2020, Volume and Issue: 20(1)

Published: Sept. 1, 2020

Abstract Background COVID-19 is known as a new viral infection. Viral-bacterial co-infections are one of the biggest medical concerns, resulting in increased mortality rates. To date, few studies have investigated bacterial superinfections patients. Hence, we designed current study on patients admitted to ICUs. Methods Nineteen our ICUs were enrolled this study. detect COVID-19, reverse transcription real-time polymerase chain reaction was performed. Endotracheal aspirate samples also collected and cultured different media support growth bacteria. After incubation, formed colonies identified using Gram staining other biochemical tests. Antimicrobial susceptibility testing carried out based CLSI recommendations. Results Of nineteen patients, 11 (58%) male 8 (42%) female, with mean age ~ 67 years old. The average ICU length stay 15 days at end study, 18 cases (95%) expired only 1 case (5%) discharged. In total, all found positive for infections, including seventeen Acinetobacter baumannii (90%) two Staphylococcus aureus (10%) strains. There no difference bacteria species detected any sampling points. Seventeen 17 strains resistant evaluated antibiotics. No metallo-beta-lactamases -producing strain found. One isolates methicillin-resistant isolated from patient who died, while another susceptible tested drugs methicillin-sensitive . Conclusions Our findings emphasize concern superinfection due Consequently, it important pay attention critical COVID-19.

Language: Английский

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Increased antimicrobial resistance during the COVID-19 pandemic

International Journal of Antimicrobial Agents, Journal Year: 2021, Volume and Issue: 57(4), P. 106324 - 106324

Published: March 20, 2021

Language: Английский

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Empiric Antibacterial Therapy and Community-onset Bacterial Coinfection in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19): A Multi-hospital Cohort Study

Clinical Infectious Diseases, Journal Year: 2020, Volume and Issue: 72(10), P. e533 - e541

Published: Aug. 19, 2020

Antibacterials may be initiated out of concern for bacterial coinfection in coronavirus disease 2019 (COVID-19). We determined prevalence and predictors empiric antibacterial therapy community-onset coinfections hospitalized patients with COVID-19.

Language: Английский

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Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors

Clinical Microbiology and Infection, Journal Year: 2020, Volume and Issue: 27(3), P. 451 - 457

Published: Oct. 24, 2020

Language: Английский

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The role of co-infections and secondary infections in patients with COVID-19

Pneumonia, Journal Year: 2021, Volume and Issue: 13(1)

Published: April 24, 2021

Abstract Background It has been recognised for a considerable time-period, that viral respiratory infections predispose patients to bacterial infections, and these co-infections have worse outcome than either infection on its own. However, it is still unclear what exact roles and/or superinfections play in with COVID-19 infection. Main body This was an extensive review of the current literature regarding SARS-CoV-2 The definitions used were those Centers Disease Control Prevention (US), which defines coinfection as one occurring concurrently initial infection, while are follow previous especially when caused by microorganisms resistant, or become antibiotics earlier. Some researchers envisioned three potential scenarios bacterial/SARS-CoV-2 co-infection; namely, secondary following colonisation, combined viral/bacterial pneumonia, superinfection SARS-CoV-2. There myriad published articles ranging from letters editor systematic reviews meta-analyses describing varying ranges co-infection COVID-19. concomitant described included other viruses, bacteria, including mycobacteria, fungi, well other, more unusual, pathogens. will be seen this review, there often not clear distinction made authors referring to, whether true concomitant/co-infections superinfections. In addition, possible mechanisms interactions between SARS-CoV-2, particularly discussed further. Lastly, impact severity their also described. Conclusion describes rates although two literature. When they occur, appear associated both poorer outcomes.

Language: Английский

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Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resource-limited settings

International Journal of Infectious Diseases, Journal Year: 2021, Volume and Issue: 104, P. 250 - 254

Published: Jan. 12, 2021

The dissemination of COVID-19 around the globe has been followed by an increased consumption antibiotics. This is related to concern for bacterial superinfection in patients. identification pathogens challenging low and middle income countries (LMIC), as there are no readily-available cost-effective clinical or biological markers that can effectively discriminate between viral infections. Fortunately, faced with threat spread, a growing awareness importance antimicrobial stewardship programs, well infection prevention control measures could help reduce microbial load hence circulation pathogens, reduction resistance. These should be improved particularly developing countries. Studies need conducted evaluate worldwide evolution resistance during pandemic, because do not respect borders. issue takes on even greater countries, where data patterns scarce, conditions infectious pathogen transmission optimal, treatment resources suboptimal.

Language: Английский

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Bacterial Coinfections in Coronavirus Disease 2019

Trends in Microbiology, Journal Year: 2021, Volume and Issue: 29(10), P. 930 - 941

Published: April 8, 2021

Bacterial coinfections occur in <4% of patients who are hospitalized with COVID-19 and usually caused by S. aureus, pneumoniae, H. influenzae.Empirical antibacterial therapy diagnostic testing for bacterial pathogens indicated only those critical illness, severe immunosuppression, radiographic findings suggestive a pneumonia, or multiple laboratory parameters compatible infection.Hospital-acquired infections common among prolonged hospitalization COVID-19, hospital-acquired pneumonia is most commonly P. aeruginosa, Klebsiella spp., aureus.Carbapenem-resistant Gram-negative being increasingly reported requiring intensive care. increase the severity respiratory viral were frequent causes mortality influenza pandemics but have not been well characterized coronavirus disease 2019 (COVID-19). The aim this review was to identify frequency microbial etiologies that present upon admission hospital during COVID-19. We found yield routine tests low. When did occur, Staphylococcus Streptococcus Haemophilus influenzae atypical bacteria rare. Although uncommon admission, frequently occurred hospitalization, Pseudomonas aureus pathogens. Antibacterial unnecessary clinicians should be vigilant nosocomial infections. Severe acute syndrome 2 (SARS-CoV-2) cause devastating pandemic has led more than 100 million cases deaths globally span 12 monthsi. Pandemics plagued humans throughout history now becoming common. Influenza responsible 1918 resulted ~50 worldwide, recently 1957, 1968, 2009 [1.Morens D.M. et al.Pandemic Joins History's Pandemic Legion.mBio. 2020; 11e00812-20Crossref PubMed Scopus (106) Google Scholar]. In 2003, near-pandemic (SARS-CoV) occurred, closely followed emergence another lethal coronavirus, Middle East (MERS-CoV), 2012 [2.Memish Z.A. al.Middle syndrome.Lancet. 395: 1063-1077Abstract Full Text PDF (306) coinfection complication many tract leads significantly increased morbidity [3.Gupta R.K. al.Bacterial planning.Emerg. Infect. Dis. 2008; 14: 1187-1192Crossref During pandemic, significant contributor nearly all deaths, upper such as β-hemolytic streptococci, influenzae, [4.Morens al.Predominant role death influenza: implications preparedness.J. 198: 962-970Crossref (1245) also occurring 18–30% admitted care unit (ICU) up 55% published autopsy series [5.Martín-Loeches I. al.Community-acquired critically ill A (H1N1) virus.Chest. 2011; 139: 555-562Abstract (146) Scholar, 6.Rice T.W. al.Critical illness from virus United States.Crit. Care Med. 2012; 40: 1487-1498Crossref (282) 7.Gill J.R. al.Pulmonary pathologic fatal A/H1N1 infections.Arch. Pathol. Lab. 2010; 134: 235-243Crossref associated risk shock failure, ICU length stay, Scholar,6.Rice coronaviruses SARS-CoV MERS-CoV clearly defined because relatively small numbers cases, multicenter study ICUs Saudi Arabia identified 19% MERS had [8.Arabi Y.M. al.Critically Respiratory Syndrome: retrospective cohort study.Crit. 2017; 45: 1683-1695Crossref (133) high clinical significance other novel raises concern could an important SARS-CoV-2 infection. initial reports described presentations outcomes [9.Guan W.J. al.Clinical characteristics China.N. Engl. J. 382: 1708-1720Crossref (20519) Scholar,10.Goyal Covid-19 New York City.N. 2372-2374Crossref (1602) Scholar], few focused on microbiological coinfections. Furthermore, these distinguish secondary acquired hospital. Thus, reviews complicating relied limited data [11.Rawson T.M. fungal co-infection individuals coronavirus: rapid support antimicrobial prescribing.Clin. 71: 2459-2468PubMed Scholar,12.Lansbury L. al.Co-infections people COVID-19: systematic meta-analysis.J. 81: 266-275Abstract (1028) However, since reports, numerous studies patients, thus our understanding evolved. Therefore, focus highlight frequency, factors, etiologies, separating hospital, evaluate diagnostics, assess multidrug-resistant (MDR) infections, provide practical guidance clinicians. reviewed publications which primary objective ten evaluated minimum (Table 1), fewer 4% documented [13.Vaughn V.M. al.Empiric community-onset multi-hospital study.Clin. (Published online August 21, 2020. https://doi.org/10.1093/cid/ciaa1239)Google 14.Wang al.An observational empirical antibiotic presenting hospitals North West London.J. Antimicrob. Chemother. 2021; 76: 796-803Crossref (65) 15.Garcia-Vidal C. al.Incidence co-infections superinfections Microbiol. 27: 83-88Abstract (585) 16.Karami Z. al.Few empiric use early phase results multicentre Netherlands.Infect. (Lond). 53: 102-110Crossref (108) 17.Hughes UK secondary-care setting.Clin. 26: 1395-1399Abstract (431) 18.Lehmann C.J. al.Community experience.Clin. July 1, https://doi.org/10.1093/cid/ciaa902)Google 19.Adler al.Low rate COVID-19.Lancet Microbe. 1e62Abstract (48) 20.Cheng L.S.-K. prescribing practice adults experience single cluster.Ther. Adv. 72049936120978095Google 21.Fu Y. al.Secondary 2019.Open Forum 5ofaa220Crossref Scholar].Table 1Bacterial Coinfections Patients Admitted Hospital COVID-19RefsLocationNo. patientsPrevalence coinfectionProportion received therapy[13.Vaughn Scholar]Michigan, USA (38 hospitals)17053.5%57% (median: 3 days)[14.Wang Scholar]London, England (2 hospitals)13962.7%98%aThe denominator proportion includes 37 randomly selected without coinfection.[15.Garcia-Vidal Scholar]Barcelona, Spain (1 hospital)9892.5%NR[16.Karami Scholar]The Netherlands (4 hospitals)9250.8%60% days)[17.Hughes hospitals)8363.2%NR[18.Lehmann Scholar]Chicago, hospital)3211.2%69%[19.Adler Scholar]Liverpool, hospital)1952.6%NR[20.Cheng Scholar]Hong Kong hospital)1472.7%35%bOf 35% antibiotics, 37% them 1 week.[21.Fu Scholar]Hangzhou, China hospital)1010%NR[22.Elabbadi A. pneumonia.Infection. https://doi.org/10.1007/s15010-020-01553-xCrossref (60) Scholar]Paris, France hospital)101 (ICU only)19.8%58%Abbreviations: ICU, unit; No., number; NR, reported.a coinfection.b Of week. Open table new tab Abbreviations: reported. Despite low prevalence coinfection, majority therapy. For example, 1705 38 Michigan hospitals, 57% median days (interquartile range: 2–6 days); however, 3.5% infection 15% agents targeting methicillin-resistant (MRSA) aeruginosa. wide disparities between treated actually highlights substantial patients. Antibiotic overuse driven uncertainty around course infectious disease, extrapolation experiences [23.Chertow D.S. Memoli M.J. grand rounds review.JAMA. 2013; 309: 275-282Crossref (315) surge lack effective therapies SARS-CoV-2. As knowledge grows, factors essential so can target high-risk Advanced age comorbidities, chronic kidney diabetes, heart some Leukocytosis two largest studies, white blood cell (WBC) counts higher compared (median approximately 10.0×109 11.3×109 cells/μl versus 7×109 cells/μl, respectively) Scholar,14.Wang Wang colleagues absolute neutrophil count 9.2×109 5.5×109 (P <0.0001) [14.Wang Vaughn procalcitonin levels leukocytosis, neutrophilia, elevated do sufficient sensitivity, specificity, positive predictive value accurately diagnose stand-alone al. level >0.5 ng/ml 9.3% Conversely, negative values WBC <8.8×109 <6.8×109 ≤0.5 ≥98%. While overall rare they 6–29% Scholar,22.Elabbadi Scholar,24.Kolenda al.Assessment 2-positive units using conventional culture BioFire, FilmArray Pneumonia Panel Plus Assay.Open 7ofaa484Crossref (42) 25.Soriano M.C. incidence co-infection, ICU-acquired COVID-19.J. 82: e20-e21Abstract (36) 26.Stevenson D.R. al.Improving stewardship critically-ill COVID-19.Clin. October 11, https://doi.org/10.1093/cid/ciaa1559)Crossref (5) 27.Contou D. French ICU.Ann. Intensive Care. 10: 119Crossref (199) 28.Dudoignon E. patients: case series.Clin. 72: 905-906Crossref (64) may related increasing cultures [17.Hughes likely Scholar,29.Caméléna F. al.Performance multiplex polymerase chain reaction panel identifying causing COVID-19.Diagn. 99115183Crossref Scholar,30.Rothe K. al.Rates light stewardship.Eur. Clin. 859-869Crossref (83) Clinicians face difficult challenge deciding treat Figure illustrates recommended approach diagnosing management recommend pursing microbiologic initiating ill, severely immunocompromised, coinfection. warranted, we β-lactam when coverage bacteria, and/or MRSA warranted. Studies demonstrated 1.2–4.2% 2) Scholar,17.Hughes Scholar,19.Adler at least half represent skin contaminants 31.Sepulveda al.Bacteremia utilization City.J. 58e00875-20Crossref (128) 32.Yu bloodstream contamination rates COVID-19.PLoS One. 15e0242533Crossref (37) perhaps part due technical challenges healthcare personnel collecting while wearing personal protective equipment (PPE) required Hospitals City (NYC) noted peak analyzed same time previous year, times overwhelmed capacity instruments [31.Sepulveda Moreover, shown lower [32.Yu initiation therapy, routinely ordered Instead, selectively suspicion would include whom initiated.Table 2Yield Diagnostic Tests Coinfection Presenting COVID-19Blood cultures: contaminants.RefsYield pathogenYield contaminant[13.Vaughn Scholar]31/1063 (2.9%)Not reported[14.Wang Scholar]12/969 (1.2%)65/969 (6.7%)[17.Hughes Scholar]21/643 (

Language: Английский

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Fungal co-infection in COVID-19 patients: Should we be concerned?

Revista Iberoamericana de Micología, Journal Year: 2020, Volume and Issue: 37(2), P. 41 - 46

Published: April 1, 2020

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