ABSTRACT
Background: Secondary bacterial pneumonia especially with multidrug resistant (MDR) organisms is one of the devastating complications that can worsen COVID-19 patients' outcomes. The study aimed to evaluate the impact of secondary MDR bacterial pneumonia on COVID-19 patients' outcomes with molecular detection of genes involved in antimicrobial resistance among isolates of the most prevalent causative pathogen. Methods: The study included 50 critically ill patients with acute severe COVID-19 with evidence of secondary MDR bacterial pneumonia, 50 critically ill patients with acute severe COVID-19 without evidence of secondary bacterial pneumonia, and 30 clinically stable patients with acute moderate COVID-19 infections. Respiratory samples were cultured for identification and antibiotic susceptibility of the causative pathogens. MDR/XDR A. baumannii, the most prevalent pathogen, was screened for multiple antibiotic resistance genes using single-plex and multiplex polymerase chain reactions. Results: Critically ill COVID-19 patients with secondary MDR bacterial pneumonia in group I had a significantly higher mortality rate. MDR/XDR A. baumannii was the most prevalent pathogen (39.2%) isolated with the highest cause specific mortality rate (38%). Multiple resistance genes were detected including blaOXA-51, blaOXA-48, blaOXA-24, blaADC, blaCIT, blaKPC, aacA4, aacC1, acc (6'), aphA1, aph6, and aadA1. Conclusion: Secondary MDR bacterial pneumonia had a significant impact on critically ill COVID-19 patients with a significantly higher mortality rate. Thus, preventing secondary MDR bacterial pneumonia through infection prevention measures, including standard precautions, preventive care bundles and antimicrobial stewardship programs, should be strictly implemented to protect critically ill COVID-19 patients and help avoid its detrimental effect on patients' outcomes. © 2020 The author (s). Published by Zagazig University.
ABSTRACT
Radiological examinations have played a crucial role in the identification and management of COVID-19 patients. Therefore, knowledge and awareness of infection control among healthcare workers in radiology departments are important to prevent disease transmission. This study aimed to assess the knowledge and practice of infection control for COVID-19 among healthcare workers in radiology departments in Saudi Arabia. A cross-sectional, online questionnaire was administered among healthcare workers in radiology departments in Saudi Arabia in May 2020. The questionnaire consisted of demographic characteristics, profession, knowledge of infection control for COVID-19, and good practice of infection control measures for COVID-19 in radiology departments. A descriptive statistical analysis and chi-square test were performed using SPSS software. A total of 234 (91%) of healthcare workers replied that they have good knowledge about the precautions needed during the examination of positive COVID-19 cases in radiology departments, and 216 (84%) replied that they knew the necessary precautions when using portable X-ray machine. Moreover, 191 (>74%) of those surveyed agreed that wearing personal protective equipment and following the CDC sequence. There was significant association between profession and good clinical practices in radiology departments regarding COVID-19. Such knowledge could limit the spread of COVID-19 among the healthcare workers in radiology departments.