Respiratory co-infections in COVID-19-positive patients

Respiratory co-infections in COVID-19-positive patients

Background Opportunistic respiratory infections may complicate critically ill patients with COVID-19. Early detection of co-infections helps to administrate the appropriate antimicrobial agent, to guard against patient deterioration. This study aimed at estimating co-infections in COVID-19-positive...

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Bibliographic Details
Published in:European journal of medical research Vol. 28; no. 1; pp. 1 - 317
Main Authors: M Abd El-Halim, Rania, Hafez, Hala, Albahet, Ibrahim, Sherif, Basma
Format: Journal Article
Language:English
Published: London BioMed Central Ltd 02-09-2023
BioMed Central
BMC
Subjects:
Antibiotics
Antifungal agents
Bacterial infections
COVID-19
Drug resistance in microorganisms
E coli
Escherichia coli
Fungal co-infections
Fungal infections
Galactomannan
Health aspects
Infection
Laboratories
Lung diseases
Medical research
Medicine, Experimental
Methicillin
Methylene blue
Morphology
Mortality
Multidrug resistance
Pandemics
Pathogens
Patients
Pneumonia
SARS-COV-2 PCR
Secondary bacterial/fungal infections
Severe acute respiratory syndrome coronavirus 2
Staphylococcus infections
Streptococcus infections
Viral infections
United Kingdom
United Kingdom > UK
United States > US
China
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Summary:Background Opportunistic respiratory infections may complicate critically ill patients with COVID-19. Early detection of co-infections helps to administrate the appropriate antimicrobial agent, to guard against patient deterioration. This study aimed at estimating co-infections in COVID-19-positive patients. Methods Eighty-nine COVID-19-positive patients confirmed by SARS-COV-2 PCR were tested for post-COVID-19 lower respiratory tract co-infections through bacterial culture, fungal culture and galactomannan (GM) testing. Results Fourteen patients showed positive coinfection with Klebsiella, nine with Acinetobacter, six with Pseudomonas and three with E. coli. As for fungal infections, nine showed coinfection with Aspergillus, two with Zygomycetes and four with Candida. Galactomannan was positive among one patient with Aspergillus coinfection, one with Zygomycetes coinfection and three with Candida, 13 samples with negative fungal culture were positive for GM. Ten samples showed positive fungal growth, however, GM test was negative. Conclusion In our study, SARS-COV-2 respiratory coinfections were mainly implicated by bacterial pathogens; most commonly Klebsiella species (spp.), Aspergillus spp. were the most common cause of fungal coinfections, GM test showed low positive predictive value for fungal infection. Respiratory coinfections may complicate SARS-COV-2 probably due to the prolonged intensive care units (ICU) hospitalization, extensive empiric antimicrobial therapy, steroid therapy, mechanical ventilation during the COVID-19 outbreak. Antimicrobial stewardship programs are required so that antibiotics are prescribed judiciously according to the culture results. Keywords: COVID-19, SARS-COV-2 PCR, Fungal co-infections, Galactomannan, Multidrug resistance, Secondary bacterial/fungal infections, Critically ill patients
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ISSN:2047-783X
0949-2321
2047-783X
DOI:10.1186/s40001-023-01305-1