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

PLoS ONE, Год журнала: 2021, Номер 16(5), С. e0251170 - e0251170

Опубликована: Май 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.

Язык: Английский

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Hospital-Acquired Infections in Critically Ill Patients With COVID-19

CHEST Journal, Год журнала: 2021, Номер 160(2), С. 454 - 465

Опубликована: Апрель 20, 2021

Язык: Английский

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Ventilator-associated pneumonia in critically ill patients with COVID-19

Critical Care, Год журнала: 2021, Номер 25(1)

Опубликована: Янв. 11, 2021

Pandemic COVID-19 caused by the coronavirus SARS-CoV-2 has a high incidence of patients with severe acute respiratory syndrome (SARS). Many these require admission to an intensive care unit (ICU) for invasive ventilation and are at significant risk developing secondary, ventilator-associated pneumonia (VAP).

Язык: Английский

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

Pneumonia, Год журнала: 2021, Номер 13(1)

Опубликована: Апрель 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.

Язык: Английский

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Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome

European Journal of Clinical Microbiology & Infectious Diseases, Год журнала: 2021, Номер 40(3), С. 495 - 502

Опубликована: Янв. 3, 2021

Язык: Английский

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COVID-19-Associated Candidiasis (CAC): An Underestimated Complication in the Absence of Immunological Predispositions?

Journal of Fungi, Год журнала: 2020, Номер 6(4), С. 211 - 211

Опубликована: Окт. 8, 2020

The recent global pandemic of COVID-19 has predisposed a relatively high number patients to acute respiratory distress syndrome (ARDS), which carries risk developing super-infections. Candida species are major constituents the human mycobiome and main cause invasive fungal infections, with mortality rate. Invasive yeast infections (IYIs) increasingly recognized as s complication severe COVID-19. Despite marked immune dysregulation in COVID-19, no prominent defects have been reported cells that critically required for immunity Candida. This suggests relevant clinical factors, including prolonged ICU stays, central venous catheters, broad-spectrum antibiotic use, may be key factors causing develop IYIs. Although data on comparative performance diagnostic tools often lacking patients, combination serological molecular techniques present promising option identification Clinical awareness screening needed, IYIs difficult diagnose, particularly setting Echinocandins azoles primary antifungal used treat IYIs, yet therapeutic failures exerted by multidrug-resistant spp. such C. auris glabrata call development new drugs novel mechanisms action.

Язык: Английский

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SARS-CoV-2 infection induces the dedifferentiation of multiciliated cells and impairs mucociliary clearance

Nature Communications, Год журнала: 2021, Номер 12(1)

Опубликована: Июль 16, 2021

Understanding how SARS-CoV-2 spreads within the respiratory tract is important to define parameters controlling severity of COVID-19. Here we examine functional and structural consequences infection in a reconstructed human bronchial epithelium model. replication causes transient decrease epithelial barrier function disruption tight junctions, though viral particle crossing remains limited. Rather, leads rapid loss ciliary layer, characterized at ultrastructural level by axoneme misorientation remaining basal bodies. Downregulation master regulator ciliogenesis Foxj1 occurs prior extensive cilia loss, implicating this transcription factor dedifferentiation ciliated cells. Motile compromised infection, as measured mucociliary clearance assay. Epithelial defense mechanisms, including cell mobilization interferon-lambda induction, ramp up only after initiation damage. Analysis Syrian hamsters further demonstrates motile vivo. This study identifies damage pathogenic mechanism that could facilitate spread deeper lung parenchyma.

Язык: Английский

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The double‐edged sword of systemic corticosteroid therapy in viral pneumonia: A case report and comparative review of influenza‐associated mucormycosis versus COVID‐19 associated mucormycosis

Mycoses, Год журнала: 2021, Номер 64(8), С. 798 - 808

Опубликована: Фев. 17, 2021

Acute respiratory distress syndrome is a common complication of severe viral pneumonia, such as influenza and COVID-19, that requires critical care including ventilatory support, use corticosteroids other adjunctive therapies to arrest the attendant massive airways inflammation. Although recommended for treatment steroid therapy appears be double-edged sword, predisposing patients secondary bacterial invasive fungal infections (IFIs) whereby impacting morbidity mortality. Mucormycosis emergency with highly aggressive tendency contiguous spread, associated poor prognosis if not promptly diagnosed managed. Classically, uncontrolled diabetes mellitus (DM) immunosuppressive conditions corticosteroid are known risk factors mucormycosis. Upon background lung pathology, immune dysfunction therapy, pneumonia likely develop IFIs like aspergillosis Notably, combination DM can augment immunosuppression hyperglycaemia, increasing mucormycosis in susceptible individual. Here, we report case sinonasal 44-year-old woman hyperglycaemia poorly controlled following dexamethasone on review 15 available literatures reported cases COVID-19

Язык: Английский

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Gut microbiota in COVID-19: key microbial changes, potential mechanisms and clinical applications

Nature Reviews Gastroenterology & Hepatology, Год журнала: 2022, Номер 20(5), С. 323 - 337

Опубликована: Окт. 21, 2022

Язык: Английский

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Bacterial Coinfections in Coronavirus Disease 2019

Trends in Microbiology, Год журнала: 2021, Номер 29(10), С. 930 - 941

Опубликована: Апрель 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 (

Язык: Английский

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