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Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study.
Son, Hyo-Ju; Kim, Tark; Lee, Eunjung; Park, Se Yoon; Yu, Shinae; Hong, Hyo-Lim; Kim, Min-Chul; Hong, Sun In; Bae, Seongman; Kim, Min Jae; Kim, Sung-Han; Yun, Ji Hyun; Jo, Kyeong Min; Lee, Yu-Mi; Lee, Seungjae; Park, Jung Wan; Jeon, Min Hyok; Kim, Tae Hyong; Choo, Eun Ju.
  • Son HJ; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Kim T; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.
  • Lee E; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
  • Park SY; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
  • Yu S; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
  • Hong HL; Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Republic of Korea.
  • Kim MC; Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea.
  • Hong SI; Department of Infectious Diseases, Gyeongsang National University Changwon Hospital, Korea.
  • Bae S; Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Kim MJ; Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Kim SH; Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Yun JH; Department of Infectious Diseases, Konkuk University Medical Center, Konkuk University School of Medicine.
  • Jo KM; Division of Infectious Disease, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
  • Lee YM; Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
  • Lee S; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
  • Park JW; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
  • Jeon MH; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
  • Kim TH; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
  • Choo EJ; Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea. Electronic address: mdchoo@schmc.ac.kr.
Am J Infect Control ; 49(10): 1256-1261, 2021 10.
Article in English | MEDLINE | ID: covidwho-1272281
ABSTRACT

OBJECTIVES:

Superimposed multi-drug resistant organisms (MDROs) co-infection can be associated with worse outcomes in patients with severe coronavirus disease 2019 (COVID-19), even if these patients were managed with strict airborne and contact precautions. Identifying risk factors for isolation of MDROs is critical to COVID-19 treatment.

METHODS:

All eligible adult patients with confirmed COVID-19 pneumonia from 10 hospitals in the Republic of Korea between February 2020 and May 2020 were retrospectively enrolled. Using this cohort, epidemiology and risk factors for isolation of MDROs were evaluated.

RESULTS:

Of 152 patients, 47 with microbial culture results were included. Twenty isolates of MDROs from 13 (28%) patients were cultured. Stenotrophomonas maltophilia (5 isolates) was the most common MDRO, followed by methicillin-resistant staphylococcus aureus (4 isolates). MDROs were mostly isolated from sputum samples (80%, 16/20). The median time from hospitalization to MDRO isolation was 28 days (interquartile range, 18-38 days). In-hospital mortality was higher in patients with MDRO isolation (62% vs 15%; P = .001). Use of systemic corticosteroids after diagnosis of COVID-19 (adjusted odds ratio [aOR] 15.07; 95% confidence interval [CI] 2.34-97.01; P = .004) and long-term care facility (LTCF) stay before diagnosis of COVID-19 (aOR 6.09; 95% CI 1.02-36.49; P = .048) were associated with MDRO isolation.

CONCLUSIONS:

MDROs were isolated from 28% of COVID-19 pneumonia patients with culture data and 8.6% of the entire cohort. Previous LTCF stay and adjunctive corticosteroid use were risk factors for the isolation of MDROs. Strict infection prevention strategies may be needed in these COVID-19 patients with risk factors.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / Methicillin-Resistant Staphylococcus aureus / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Am J Infect Control Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / Methicillin-Resistant Staphylococcus aureus / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Am J Infect Control Year: 2021 Document Type: Article