Characterization of secondary bacterial and fungal infections in ICU hospitalized patients with COVID-19: retrospective observational study

Introduction: We aimed to describe the incidence, risk factors, and clinical outcomes of bacterial and fungal co-infections and superinfections in intensive care patients with COVID-19 in a retrospective observational study. Method(s): A retrospective cohort of intensive care patients with confirmed SARS-CoV-2 by PCR was analysed from January to March 2021. This was contrasted to a control group of influenza-positive patients admitted during 2012-2022. Patient demographics, microbiology and clinical outcomes were analysed. Result(s): A total of 70 patients with confirmed SARS-CoV-2 were included;6 (8.6%) of 70 had early bacterial isolates identified rising to 42 (60%) of 70 throughout admission. Blood cultures, respiratory samples, and urinary samples were obtained from 66 (94.3%), 18 (25.7%) and 61 (87.1%) COVID-19 patients. Positive blood culture was identified in 13 patients (18.6%). Bacteraemia resulting from respiratory infection was confirmed in 3 cases (all ventilator-associated). Line-related bacteraemia was identified in 9 patients (6 Acinetobacter baumannii, 4 Enterococcus spp. and 1 Pseudomonas aeruginosa and 1 Micrococcus lylae). No concomitant pneumococcal, Legionella or influenza co-infection was detected. Invasive fungal infections with Aspergillus spp. were identified in 2 cases. Pneumococcal coinfections (7/68;10.3%) were identified in the control group of confirmed influenza infection;clinically relevant bacteraemias (6/68;8.8%), positive respiratory cultures (15/68;22.1%). The rate of hospital- acquired infections was 51.4% for COVID-19 and 27.9% for influenza. Longer intensive care stay, type 2 diabetes, obesity and hematologic diseases were independent risk factors for superinfections in the COVID-19 cohort. Conclusion(s): Respiratory coinfections occurred in influenza but not in COVID-19 patients. The rate of hospital-acquired infections (51.4% for COVID-19;27.9% for influenza) was unexpectedly high in both groups.

Ozone disinfection efficiency against airborne microorganisms in hospital environment: a case study.

Even though ozone has shown its potential for air disinfection in hospital environment, its more frequent use has earned attention only with the COVID-19 pandemic due to its proven antimicrobial effect and low cost of production. The aim of this study was to determine its antimicrobial efficiency against the most common bacterial species in a real-life setting, that is, in the air of one postoperative room of the General Hospital Dr Ivo Pedisic (Sisak, Croatia). Air was sampled for aiborne bacteria before and after treatment with the ozone concentration of 15.71 mg/m3 for one hour. The most dominant Gram-positive bacteria of the genera Micrococcus, Staphylococcus, and Bacillus were reduced by 33 %, 58 %, and 61 %, respectively. The genus Micrococcus proved to be the most resistant. Considering our findings, we recommend longer air treatment with higher ozone concentrations in combination with mechanical cleaning and frequent ventilation.

Treatment of post-COVID-19 patients with chronic recurrent prostatitis: efficacy of recombinant interferon alpha-2b medications.

Introduction. The tactics of managing and treating patients with chronic recurrent bacterial prostatitis (CRBP) in some cases is a difficult-to-treat condition for a practicing urologist. This circumstance occurs because the disease has several predisposing factors, a complex and multifaceted pathogenesis, and certain difficulties in diagnosis and treatment. Objective. To study the effectiveness of recombinant interferon alpha-2b medications in post-COVID-19 patients with chronic recurrent prostatitis against the background of antibiotic multi-drug resistance of microorganisms verified in prostate secretion. Materials and methods. The treatment of 52 post-COVID-19 patients with CRBP was analyzed, divided into three therapy-dependent groups. Group 1 patients (n = 18) received antibiotic therapy (ABT): Levofloxacin 500 mg q.d. PO for 28 days. Group 2 patients (n = 18) underwent combined therapy: ABT supplemented with recombinant interferon alpha-2b with an antioxidant complex of vitamins E and C ("Viferon" rectal suppositories) 3.000.000 IU b.i.d. PR q12h for 28 days. Group 3 patients (n = 16) received monotherapy with recombinant interferon alpha-2b with an antioxidant complex of vitamins E and C ("Viferon"rectal suppositories) 3.000.000 IU b.i.d. PR q12h for 28 days. The follow-up period was 6 months with monitoring of clinical and laboratory parameters assessed before treatment, after 1, 3 and 6 months from the start of therapy. Results. Based on the monitoring of the clinical picture and laboratory parameters, after 1 follow-up month, there was a significant decrease in the symptoms of the disease in all study groups. However, after 3 and 6 follow-up months, this trend was observed only in patients of groups 2 and 3 receiving recombinant interferon alfa-2b with an antioxidant complex (vitamins E and C). Conclusions. Strengthening the standard CRBP-therapy with recombinant interferon alpha-2b with an antioxidant complex of vitamins E and C makes it possible to normalize both clinical and laboratory parameters in most patients.Copyright © Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.

Use of Micrococcus luteus to assess the quality of protection of respiratory organs using the pneumatic helmet with positive airflow.

In order to effectively protect from dangerous infectious agents, as well as coronavirus, the scientists of I. Horbachevsky Ternopil national medical university (Ukraine) developed a unique prototype of a mobile respiratory protection system with positive airflow - pneumatic helmet. AIM: To evaluate the bacterial permeability of the proposed concept model of the pneumohelmet in full and partial configuration. MATERIALS AND METHODS: With a generating device (compressor inhaler) an aerosol is created from bacterial suspension, which is directed to the inlet of the personal protective respiratory equipment. The outlet is directed at a Petri dish with meat-peptone broth. Evaluation of bacterial contamination is performed by calculating the colony-forming units by multiplying the indicator by the degree of dilution. The study is repeated with a partial configuration of the pneumatic helmet - the presence of only external, only internal filter or not using any filter components. RESULTS: The growth of Micrococcus luteus colonies on the placed nutrient medium when using the proposed conceptual model of the pneumatic helmet in full configuration was not obtained. Removal of the inner filter did not lead to a violation of the effectiveness of antibacterial protection, as bacteria were detected only on the outer side of filter No.2. The use of a conceptual model without filters made it possible to detect colonies of Micrococcus luteus on the medium and components of the device with the calculation of colony forming units in 3- and 4-fold dilutions. During 24 hours of operation, the bacterial load on the surface of the external filter increased significantly. However, no signs of malfunction of the pneumatic helmet were detected. CONCLUSIONS: The given results confirm the ability of the pneumatic helmet to counteract the penetration of bacteria from the environment during 6, 12, 24 hours of continuous operation. The protection was preserved even with partial configuration, which indicates the presence of a margin of reliability of this system.

Bacterial pattern in adult decompensated liver cirrhosis ascitic fluid infection during first 5 months of second wave Covid-19 pandemic at tertiary hospitals in Jakarta Indonesia

Objectives: To find out bacterial pattern of ascitic bacterial infection in adult decompensated liver cirrhosis during Covid-19 pandemic at three tertiary referral hopsitals in Jakarta. Materials and Methods: 18 years old or more decompensated liver cirrhosis patient due to any cause with grade 2 or more ascites admitted consecutively to emergency room, inpatient and outpatient unit in Jakarta's three tertiary referral hospitals: Cipto Mangunkusumo National General Hospital, Gatot Soebroto Central Army Hospital, Fatmawati General Hospital would be performed paracentesis ascitic tap during January to May 2021. Bedsite aerobic and anaerobic bacterial blood culture bottles of 10 mL inoculation ( aerobic BACT/ALERT® FA Plus and anaerobic BACT/ALERT® FN Plus bioMerieux Incorporation) were acquired under aseptic and antiseptic standards before antibiotic administration or at least 4 h after it. Diphtheroids species, Bacillus species and Staphylococcus epidermidis were considered contaminant. Results: There were 98 ascitic culture specimens from 98 grade 2 and more ascites decompensated liver cirrhosis patients. Basic characterisitic data included: 32.6% female, 67.4% male, history of hospitalization and antibiotic admission in the last previous 3 months 76.5%, due to viral hepatitis B 38.5%. Bacterial growth was found in 11 specimens ( 11.1%) including 6 aerobic gram negative ( 54.5%): Aeromonas hydrophila, Enterobater aerogenes, Klebsiella pneumonia ( 2 specimens), Acinetobacter species, Pseudomonas aeruginosa and 5 aerobic gram positive ( 45.4%): Enterococcus faecalis, Staphylococcus cohnii ssp cohnii, Staphylococcus cohnii ssp urealyticus, Staphylococcus haemolyticus, Micrococcus luteus. There were no positive culture for Escherichia coli and anaerobic bacteria. Conclusion: During second wave of Covid-19 pandemic in Jakarta, there were almost equal proportion of gram positive and negative bacterial in adult decompensated liver cirrhosis ascitic fluid bacterial infection patients in tertiary hospitals. This result reminds clinicians of bacterial pattern shift in ascitic fluid infection in decompensated liver cirrhosis during pandemic.

Antimicrobial Resistance of Secondary Bacterial Infections in Patients Hospitalized with Covid-19

Coronavirus disease 2019 (COVID-19) is an emerging serious global health problem. It has been recognised for a considerable time-period, that viral respiratory infections predispose patients to bacterial infections, and that these co-infections have a worse outcome than either infection on its own. This study was carried out on 100 samples of sputum from COVID-19 patients. During the laboratory diagnosis, 156 bacterial isolates were obtained from the positive samples . The Gram-positive bacteria isolates included Strptococcus pneumonia 64(40%) Streptococcus pyogenes, 7 (4%), Streptococcus mitis 1 (1%) Streptococcus mutus 1(1%), Streptococcus parasanguinis 1(1%) Staphylococcus eidermidis 10(6%), staphylococcus aureus 4 (2%), Micrococcus lutus,1 (1%). Whereas, Gram-negtive bacteria included Pseudomonas aeruginosa 9 (6%), E coli 10 (6%), Serratia marcescens, 3 (2%), Klebsiella pneumonia 31 (19%), H.influenzae 10 (6%) Acinetobacter baumannii, 4 (2%) .The isolates varied in their response against the antibiotics;and Gram positive bacteria were significantly (p<0.05) more sensitive to the antibiotic then Gram negative. To detect the Streptococcus pneumonia isolates, the house keeping Eno genes was screened. Results showed that all the isolates, had Eno gene (100%). Furthermore, This study was carried out in order to detect tet-L and ermB gene in 10 S.pneumonia isolates . genes were Results showed that all the isolates, numbering 10, had both tetL and ermB genes(100%).