Evaluation of bacterial co-infections in COVID-19 patients admitted in ICU

ABSTRACT

Background:COVID-19 is a new viral infection. Viral- bacterial co-infections are one of the biggest medical concerns, resulting in in- creased mortality rates. To date, few studies have investigated bacterial superinfections in COVID-19 patients admitted to ICUs. Methods:A total 43 patients admitted to our ICUs were enrolled in this study. To detect COVID-19, real - time polymerase chain reac- tion was performed. Pleural fluid, blood & sputum samples were collected from symptomatic patients and then all the samples were processed and bacterial identification was done using standard microbiological techniques. Antimicrobial susceptibility testing was carried out based on the CLSI recommendations. Results:Of 43 COVID -19 patients, 26 (60.46%) patients were male & 17 (39.53%) patients were female, with a mean age of 65 years. The average ICU length of stay was approximately 20 days. Among all admitted patients, 31 patients were found positive for bacterial infections & 12 patients were negative. Most common isolates were Staphylococcus aureus (11) & Pseudomonas aeruginosa (8). Oth- ers were Acinetobacter baumanii (6), Klebsiella pneumoniae (3), Enterococcus species (2) & coagulase negative staphylococcus spe- cies. All of the staphylococcus aureus isolates were detected as methicillin- resistant staphylococcus aureus & out of which 1 was detected as vancomycin resistant staphylococcus aureus. All of the staphyloccus isolates were sensitive to linezolid & also they were sensitive to vancomycin except one isolate. All isolates of Pseudo- monas aeruginosa, Klebsiella pneumonia & Acinetobacter baumanii were 100% sensitive to Colistin & have shown different percentage of sensitivity to other antibiotics. All isolates of enterococcus & coagulase negative staphylococcus species were sensitive to gen- tamicin, linezolid & vancomycin. [Formula presented] Conclusions: Our findings emphasize the concern of superinfection in COVID-19 patients due to Staphylococcus aureus & Pseudomonas aeruginosa. Consequently it is important to pay attention to bacteri- al co-infections in critical patients positive for COVID-19.