The emergence of multi-drug-resistant bacteria causing healthcare-associated infections in COVID-19 patients: a retrospective multi-centre study

Journal of Hospital Infection, Год журнала: 2023, Номер 137, С. 1 - 7

Опубликована: Апрель 28, 2023

Язык: Английский

---

The Unseen Aftermath: Associations Between the COVID-19 Pandemic and Shifts in Mortality Trends in Japan

International Journal of Environmental Research and Public Health, Год журнала: 2025, Номер 22(1), С. 74 - 74

Опубликована: Янв. 8, 2025

The COVID-19 pandemic disrupted healthcare systems globally, potentially altering mortality trends for non-COVID-19 diseases, particularly in aging populations like Japan's. Assessing these impacts is essential responsive planning. We analyzed Japanese vital registration records from January 2018 to December 2021 adults aged 25 and older, excluding COVID-19-related deaths. Data were stratified by sex ICD-10 cause-of-death chapters. Poisson regression models assessed changes rates trends, incorporating pandemic-related variables interactions between time, age group, the term. Among 4,920,942 deaths analyzed, 2,456,750 occurred during years. Significant sex-specific observed. Women experienced increases endocrine, nutritional, metabolic diseases; skin subcutaneous tissue circulatory genitourinary reversing some pre-pandemic declines. Men showed diseases but no significant or diseases. These findings indicate that differentially affected sexes, with women experiencing broader across multiple disease categories. was associated certain Japan, notable differences. Increased among categories highlights pandemic's indirect health underscores need strategies post-pandemic era.

Язык: Английский

---

The association between early corticosteroid use and the risk of secondary infections in hospitalized patients with COVID-19: a double-edged sword. Results from the international SCCM discovery viral infection and respiratory illness universal study (VIRUS) COVID-19 registry

Frontiers in Medicine, Год журнала: 2025, Номер 12

Опубликована: Фев. 14, 2025

Background Corticosteroids improve survival in hospitalized COVID-19 patients needing supplemental oxygen. However, concern exists about increased risk of secondary infections. This study investigated the impact early corticosteroids use on these Methods Data from Society Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): registry were analyzed for adult patients, stratified by corticosteroid (within 48 h admission). The primary outcome was documented infections, including bacteremia, bacterial pneumonia, empyema, meningitis/encephalitis, septic shock, ventilator-associated pneumonia. Univariate multivariable logistic regression models used to assess association between outcomes. Results Among 17,092 eligible with 13.5% developed at least one infection during hospitalization. Patients receiving older (median 63 years) compared those who did not 60 years), a similar gender distribution (42.5% vs. 44.2% female). Unadjusted analysis revealed higher any (OR 1.93, 95% CI 1.76–2.12). persisted specific infections bacteremia 2.0, 1.58–2.54), pneumonia 1.5, 1.27–1.77), shock 1.67, 1.44–1.93). effect meningitis/encephalitis 0.62, 0.24–1.57) (VAP; OR 1.08, 0.75–1.57) non-significant. Adjusted maintained significance 1.15, 1.02–1.29), 1.43, 1.09–1.88), unknown sources 1.63, 1.31–2.02). Notably, weakened became non-significant 0.98, 0.81–1.20) 0.94, 0.79–1.11), while it significant 0.26, 0.08–0.82). VAP remained 0.87, 0.56–1.34). Conclusion Early overall but varied. Risk notably increased, after adjustment becoming surprisingly reduced noted suggesting complexity effects. Further research is needed understand how influence thereby optimize treatment strategies.

Язык: Английский

---

Predictors and etiology of healthcare-associated infections in patients with severe community-acquired pneumonia

Messenger of Anesthesiology and Resuscitation, Год журнала: 2025, Номер 22(1), С. 40 - 56

Опубликована: Фев. 21, 2025

Introduction. The increasing prevalence of healthcare-associated infections (HAIs) caused by critical, high and medium priority pathogens among patients with severe community-acquired pneumonia (SCAP) the mortality rate necessitate monitoring consideration predictors. objective was to identify predictors, determine etiology evaluate dynamics HAIs over a 10-year period in SCAP. Materials methods . An analysis medical records 756 treated intensive care unit I.I. Mechnikov NWSMU conducted from 2013 2023. Incidents (catheter-associated urinary tract infection – CAUTI, catheter-associated bloodstream CLABSI) ventilator-associated VAP) were determined accordance NASCI criteria Results. study included 663 density SCAP 6.2/1000 days device use (DDU) shows an increase 2021–2023. frequency CLABSI multiple drug resistance (MDR) 69.2%, CAUTI 24.4%, VAP 42.9%. 72 cases HAI registered 67 patients, which 24 (35,8%) had 50 critical pathogens, 16 (23.8%) bacterial-fungal associations. registration DAIs for entire analyzed carbapenem-resistant strains A. baumannii K. pneumoniae as well isolates resistant third-generation cephalosporins. A trend towards expanding spectrum proportion Candida non-albicans etiological structure fungal identified Independent predictors SCAP, > 7 DDU CLABSI, hours mechanical ventilation VAP, procalcitonin 0.5 ng/ml CAUTI. When registering severity comorbidities (CCI score ≥ 5: 3.829; 1.867–7.852, p < 0.001) organ dysfunction (SOFA 4.0 (9.976; 1.277–77.958, = 0.028) COVID-19 independent HAIs. Conclusion. In 2021–2023, observed group main pneumoniae, baumannii, spp. (C. tropicalis, С. parapsilosis, P. kudriavzevii). identified, duration devices level above ng/ml. risk factors such identified.

Язык: Английский

---

Failure to achieve pharmacodynamic targets in critically Ill COVID-19 patients receiving antibiotics: A hypothesis-generating secondary analysis from the DOLPHIN study

Journal of Critical Care, Год журнала: 2025, Номер 89, С. 155102 - 155102

Опубликована: Май 6, 2025

Язык: Английский

---

Bacterial Superinfections After SARS-CoV-2 Pneumonia: Antimicrobial Resistance Patterns, Impact on Inflammatory Profiles, Severity Scores, and Clinical Outcomes

Diseases, Год журнала: 2025, Номер 13(5), С. 145 - 145

Опубликована: Май 9, 2025

Background and Objectives: Secondary bacterial pneumonia can substantially worsen the clinical trajectory of patients hospitalized for Coronavirus Disease 2019 (COVID-19). This study aimed to characterize superinfections in COVID-19, including pathogen profiles, resistance patterns, inflammatory responses, severity scores, ICU admission risk. Methods: In a retrospective cohort design, we reviewed 141 admitted single tertiary-care hospital between February 2021 December 2024. A total 58 had laboratory-confirmed superinfection by sputum, bronchoalveolar lavage, or blood cultures (superinfection group), whereas 83 COVID-19 without any documented pathogens (COVID-only group). We collected detailed microbiological data from lavage (BAL), cultures. Antibiotic sensitivity testing was performed using standard breakpoints multidrug (MDR). Inflammatory markers (C-reactive protein, procalcitonin, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index) indices Acute Physiology Chronic Health Evaluation (APACHE) II, Confusion, Urea, Respiratory rate, Blood pressure (CURB), National Early Warning Score (NEWS) were measured at admission. Primary outcomes included intensive care unit (ICU) admission, mechanical ventilation, mortality. Results: Patients group showed significantly elevated scores compared COVID-only (mean APACHE II 17.2 vs. 13.8; p < 0.001). Pathogens most frequently isolated sputum BAL Klebsiella pneumoniae (27.6%) Pseudomonas aeruginosa (20.7%). Multidrug-resistant strains 32.8% isolates. The higher admissions (37.9% 19.3%; = 0.01) more frequent ventilation (25.9% 9.6%; 0.01). Mortality trended among superinfected (15.5% 7.2%; 0.09). 34% prior antibiotic use, which independently predicted MDR (aOR 2.6, presence such as (OR 2.8), 2.5), Staphylococcus aureus 2.1) increases risk Conclusions: Bacterial exacerbates inflammation worsens patients,

Язык: Английский

---

Development and validation of machine learning-based models for predicting healthcare-associated bacterial/fungal infections among COVID-19 inpatients: a retrospective cohort study

Antimicrobial Resistance and Infection Control, Год журнала: 2024, Номер 13(1)

Опубликована: Апрель 14, 2024

Abstract Background COVID-19 and bacterial/fungal coinfections have posed significant challenges to human health. However, there is a lack of good tools for predicting coinfection risk aid clinical work. Objective We aimed investigate the factors among patients develop machine learning models estimate coinfection. Methods In this retrospective cohort study, we enrolled adult inpatients confirmed with in tertiary hospital between January 1 July 31, 2023, China collected baseline information at admission. All data were randomly divided into training set testing ratio 7:3. developed generalized linear random forest assessed performance set. Decision curve analysis was performed evaluate applicability. Results A total 1244 included 62 healthcare-associated infections, while 534 22 infections. found that comorbidities (diabetes, neurological disease) greater than those without (OR = 2.78, 95%CI 1.61–4.86; OR 1.93, 1.11–3.35). An indwelling central venous catheter or urinary also associated an increased 2.53, 1.39–4.64; 2.28, 1.24–4.27) coinfections. Patients PCT > 0.5 ng/ml 2.03 times (95%CI 1.41–3.82) more likely be infected. Interestingly, IL-6 concentration < 10 pg/ml 1.69, 0.97–2.94). low creatinine levels had decreased coinfections(OR 0.40, 0.22–0.71). The demonstrated favorable receiver operating characteristic curves (ROC 0.87, 0.80–0.94; ROC 0.88, 0.82–0.93) high accuracy, sensitivity specificity 0.86vs0.75, 0.82vs0.86, 0.87vs0.74, respectively. corresponding calibration evaluation P statistics 0.883 0.769. Conclusions Our achieved strong predictive ability may effective decision-support identifying guiding antibiotic administration. cytokines, such as IL-6, affect status

Язык: Английский

---

The “COVID effect” in culture-based clinical microbiology: Changes induced by COVID-19 pandemic in a Hungarian tertiary care center

Journal of Infection and Public Health, Год журнала: 2024, Номер 17(7), С. 102453 - 102453

Опубликована: Май 17, 2024

The presence of bacterial and fungal coinfections plays an important role in the mortality patients with coronavirus 2019 (COVID-19). We compared data from 3 years before after COVID-19 pandemic outbreak to evaluate its effect on traits diseases. retrospectively collected analyzed positive respiratory tract samples (n = 13,133 7717 patients) blood cultures 23,652 9653 between 2017 2022 Clinical Center University Szeged, Hungary. also evaluated antimicrobial susceptibility test results derived 169,020 549,729 gain insight into changes resistance. most common pathogen pre-COVID era was Pseudomonas aeruginosa, whereas Candida albicans frequent during pandemic. number isolates Acinetobacter baumannii markedly increased. In cultures, Staphylococcus epidermidis, Escherichia coli, S. aureus were dominant study period, A. widespread years. Resistance ofloxacin, penicillin, piperacillin-tazobactam, ceftazidime, cefepime, imipenem, ceftolozane-tazobactam, itraconazole increased significantly COVID era. During pandemic, there prevalence culture pathogens at Szeged. C. became predominant pathogen, dramatically. Additionally, resistance notably this period.

Язык: Английский

---

Real-World Safety and Effectiveness of Remdesivir and Corticosteroids in Hospitalized Patients with COVID-19

COVID, Год журнала: 2023, Номер 3(2), С. 198 - 217

Опубликована: Фев. 5, 2023

Real-world effectiveness studies of remdesivir in hospitalized patients with COVID-19 conducted to date have produced conflicting findings which may be due, part, treatment heterogeneity within standard care comparison groups. Our objective was evaluate the comparative and safety a cohort all treated corticosteroids. We retrospective study National Veterans Affairs Healthcare System. included (>18 years old) positive PCR tests diagnosis codes, corticosteroid 2 days admission, from 1 May 2020 30 November 2021. Time-to-event outcomes time inpatient mortality (primary), discharge, after readmission, acute kidney injury bacterial infection initiation. Propensity score (PS)-adjusted, PS-matched, inverse probability weighted (IPTW) Cox proportional hazards regression models controlled for timeframe, supplemental oxygen, vaccination status, other important confounders. observed significantly lower mortality, 90-day post-discharge 30-day longer hospital stays group (n = 14,509) compared non-remdesivir 4365). Higher rates infections were group. Acute subgroup analyses restricting population index dates 2021, on fully vaccinated, higher those without baseline oxygen. When comparing plus corticosteroids homogenous group, also corticosteroids, readmission Longer length stay corresponds duration impact risk developing during hospitalization, requires further study.

Язык: Английский

---

SARS-CoV-2 and Influenza Co-Infection: Fair Competition or Sinister Combination?

Опубликована: Апрель 19, 2024

The COVID-19 pandemic remains a serious public health problem globally. During winter flu seasons, more aggressive SARS-CoV-2 infections with fatalities have been documented, indicating that influenza co-infections may significantly impact the disease outcome of COVID-19. Both and viruses share many similarities in their transmission cellular tropism for replication human respiratory tract. However, it is still unclear how two pathogens interplay to ensure survival same lung microenvironment. In addition, clinical studies on patients do not provide conclusive evidence co-infection mechanistically modifies This mini-review discusses various viral as well host factors potentially influence or synergism these infected

Язык: Английский

---