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Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single Center Experience.
Karruli, Arta; Boccia, Filomena; Gagliardi, Massimo; Patauner, Fabian; Ursi, Maria Paola; Sommese, Pino; De Rosa, Rosanna; Murino, Patrizia; Ruocco, Giuseppe; Corcione, Antonio; Andini, Roberto; Zampino, Rosa; Durante-Mangoni, Emanuele.
  • Karruli A; Department of Precision Medicine, University of Campania "L. Vanvitelli", Napoli, Italy.
  • Boccia F; Department of Precision Medicine, University of Campania "L. Vanvitelli", Napoli, Italy.
  • Gagliardi M; Department of Precision Medicine, University of Campania "L. Vanvitelli", Napoli, Italy.
  • Patauner F; Department of Precision Medicine, University of Campania "L. Vanvitelli", Napoli, Italy.
  • Ursi MP; Department of Precision Medicine, University of Campania "L. Vanvitelli", Napoli, Italy.
  • Sommese P; Department of Precision Medicine, University of Campania "L. Vanvitelli", Napoli, Italy.
  • De Rosa R; Intensive Care Unit, AORN Ospedali dei Colli-Monaldi Hospital, Napoli, Italy.
  • Murino P; Intensive Care Unit, AORN Ospedali dei Colli-Monaldi Hospital, Napoli, Italy.
  • Ruocco G; Microbiology and Virology Laboratory, AORN Ospedali dei Colli-Monaldi Hospital, Napoli, Italy.
  • Corcione A; Intensive Care Unit, AORN Ospedali dei Colli-Monaldi Hospital, Napoli, Italy.
  • Andini R; Unit of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Napoli, Italy.
  • Zampino R; Unit of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Napoli, Italy.
  • Durante-Mangoni E; Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Napoli, Italy.
Microb Drug Resist ; 27(9): 1167-1175, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1406451
Semantic information from SemMedBD (by NLM)
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Subject
Critical Illness
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PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
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COVID-19
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Patients
3. CD69 protei ASSOCIATED_WITH C5203670
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CD69 protei
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ASSOCIATED_WITH
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4. resistant infection PROCESS_OF Patients
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resistant infection
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PROCESS_OF
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5. Acinetobacter calcoaceticus CAUSES Pneumonia
Subject
Acinetobacter calcoaceticus
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CAUSES
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Pneumonia
6. Acinetobacter calcoaceticus CAUSES Sepsis
Subject
Acinetobacter calcoaceticus
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CAUSES
Object
Sepsis
7. Carbapenem resistant Klebsiella pneumoniae CAUSES Sepsis
Subject
Carbapenem resistant Klebsiella pneumoniae
Predicate
CAUSES
Object
Sepsis
8. Carbapenem resistant Klebsiella pneumoniae CAUSES Pneumonia
Subject
Carbapenem resistant Klebsiella pneumoniae
Predicate
CAUSES
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Pneumonia
9. Resistance Process PROCESS_OF Patients
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Resistance Process
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Patients
10. Complication PROCESS_OF Patients
Subject
Complication
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PROCESS_OF
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Patients
11. Critical Illness PROCESS_OF Patients
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Critical Illness
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Patients
12. COVID-19 PROCESS_OF Patients
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CD69 protein, human|CD69
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ASSOCIATED_WITH
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COVID-19
14. resistant infection PROCESS_OF Patients
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resistant infection
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PROCESS_OF
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Patients
15. Acinetobacter calcoaceticus CAUSES Pneumonia
Subject
Acinetobacter calcoaceticus
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CAUSES
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Pneumonia
16. Acinetobacter calcoaceticus CAUSES Sepsis
Subject
Acinetobacter calcoaceticus
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CAUSES
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Sepsis
17. Carbapenem resistant Klebsiella pneumoniae CAUSES Sepsis
Subject
Carbapenem resistant Klebsiella pneumoniae
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CAUSES
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Sepsis
18. Carbapenem resistant Klebsiella pneumoniae CAUSES Pneumonia
Subject
Carbapenem resistant Klebsiella pneumoniae
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CAUSES
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Pneumonia
19. Resistance Process PROCESS_OF Patients
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Resistance Process
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ABSTRACT

Background:

The aim of this study was to assess the drivers of multidrug-resistant (MDR) bacterial infection development in coronavirus disease 2019 (COVID-19) and its impact on patient outcome.

Methods:

Retrospective analysis on data from 32 consecutive patients with COVID-19, admitted to our intensive care unit (ICU) from March to May 2020. Outcomes considered were MDR infection and ICU mortality.

Results:

Fifty percent of patients developed an MDR infection during ICU stay after a median time of 8 [4-11] days. Most common MDR pathogens were carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii, causing bloodstream infections and pneumonia. MDR infections were linked to a higher length of ICU stay (p = 0.002), steroid therapy (p = 0.011), and associated with a lower ICU mortality (odds ratio 0.439, 95% confidence interval 0.251-0.763; p < 0.001). Low-dose aspirin intake was associated with both MDR infection (p = 0.043) and survival (p = 0.015). Among MDR patients, mortality was related with piperacillin-tazobactam use (p = 0.035) and an earlier onset of MDR infection (p = 0.042).

Conclusions:

MDR infections were a common complication in critically ill COVID-19 patients at our center. MDR risk was higher among those dwelling longer in the ICU and receiving steroids. However, MDR infections were not associated with a worse outcome.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Opportunistic Infections / Acinetobacter Infections / Klebsiella Infections / Drug Resistance, Multiple, Bacterial / SARS-CoV-2 / COVID-19 Type of study: Observational study / Risk factors Language: English Journal: Microb Drug Resist Journal subject: Microbiology / Drug Therapy Year: 2021 Document Type: Article Affiliation country: MDR.2020.0489

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Opportunistic Infections / Acinetobacter Infections / Klebsiella Infections / Drug Resistance, Multiple, Bacterial / SARS-CoV-2 / COVID-19 Type of study: Observational study / Risk factors Language: English Journal: Microb Drug Resist Journal subject: Microbiology / Drug Therapy Year: 2021 Document Type: Article Affiliation country: MDR.2020.0489