A Retrospective Analysis of the Bacterial Infections, Antibiotic Use, and Mortality Predictors of COVID-19 Patients

• Published in: International journal of general medicine Vol. 15; pp. 3591 - 3603
• Main Authors: Suranadi, I Wayan, Sucandra, I Made Agus Kresna, Fatmawati, Ni Nengah Dwi, Wisnawa, Ayu Dilia Febriani
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 30-04-2022; Dove; Dove Medical Press
• Subjects: Antibiotics; Bacterial infections; China; Comorbidity; Computer industry; Coronaviruses; covid-19; Diabetes; Indonesia; Infection; keywords: antibiotics; Mortality; Original Research; Patient outcomes; United States; United States; China; Indonesia; COVID-19; mortality; bacterial infections; antibiotics
• ISSN: 1178-7074; 1178-7074
• DOI: 10.2147/IJGM.S351180

This study aimed to investigate the rate and profile of bacterial infections, mortality-associated predictors, and report the most common microorganisms and antibiotic use in coronavirus disease-19 (COVID-19) patients.
This study used a retrospective approach to evaluate the bacterial culture, antibiotic use, comorbidities, imaging, and laboratory discoveries of patients with COVID-19 (hospitalized) confirmed by reverse transcription polymerase chain reaction (RT-PCR) between May and December 2020. We have selected 906 COVID-19 positive patients using a consecutive sampling technique and analyzed data using IBM SPSS-22 statistical software. Statistical analysis included univariate, bivariate, and multivariate analysis. It was carried out using multivariable logistic regression analysis to predict the mortality of COVID-19 patients.
A total of 410 patients, which involved 247 males with a mean age of 53.9 years were evaluated. Based on the results, the positive bacterial culture was detected in 18.3% of all patients who sent the culture sample test, representing bacterial infections. The
was the most commonly identified organism, while the proportion of patients treated with antibiotics was 83.4%. Furthermore, azithromycin was prescribed in the highest number of patients with approximately 44.3% of all antibiotics. The total mortality rate was 39.8% and its ratio was higher in COVID-19 patients with bacterial infections (65.3%, X
= 25.1,
<0.001). Patients mortality who used antibiotics were also higher compared to those who did not (89% vs 11%,
<0.014). Age, length of hospitalization, bacterial infection, shortness of breath, neutrophil-to-lymphocyte ratio (NLR), and diabetes mellitus were also associated predictors to increased hospital mortality (adjusted OR (aOR) 0.382,
<0.013; aOR 4.265,
<0.001; aOR 3.720,
<0.001; aOR 3.889,
<0.001; aOR 6.839,
<0.003; aOR 1.844,
<0.030), respectively.
This study discovered that there is high use of antibiotics amongst COVID-19 patients; however, the bacterial infection rates did not exceed one-fifth of the total patients. Furthermore, older age, bacterial infections, a longer length of hospitalization, diabetes mellitus, shortness of breath, and higher NLR have a significant impact on the mortality of COVID-19 patients.