Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis
Abstract Background A considerable proportion of patients hospitalized with coronavirus disease 2019 (COVID-19) acquired secondary bacterial infections (SBIs). The etiology and antimicrobial resistance of bacteria were reported and used to provide a theoretical basis for appropriate infection therap...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | http://link.springer.com/article/10.1186/s13756-020-00819-1 |
| _version_ | 1819012992239403008 |
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| author | Jie Li Junwei Wang Yi Yang Peishan Cai Jingchao Cao Xuefeng Cai Yu Zhang |
| author_facet | Jie Li Junwei Wang Yi Yang Peishan Cai Jingchao Cao Xuefeng Cai Yu Zhang |
| author_sort | Jie Li |
| collection | DOAJ |
| description | Abstract Background A considerable proportion of patients hospitalized with coronavirus disease 2019 (COVID-19) acquired secondary bacterial infections (SBIs). The etiology and antimicrobial resistance of bacteria were reported and used to provide a theoretical basis for appropriate infection therapy. Methods This retrospective study reviewed electronic medical records of all the patients hospitalized with COVID-19 in the Wuhan Union Hospital between January 27 and March 17, 2020. According to the inclusion and exclusion criteria, patients who acquired SBIs were enrolled. Demographic, clinical course, etiology, and antimicrobial resistance data of the SBIs were collected. Outcomes were also compared between patients who were classified as severe and critical on admission. Results Among 1495 patients hospitalized with COVID-19, 102 (6.8%) patients had acquired SBIs, and almost half of them (49.0%, 50/102) died during hospitalization. Compared with severe patients, critical patients had a higher chance of SBIs. Among the 159 strains of bacteria isolated from the SBIs, 136 strains (85.5%) were Gram-negative bacteria. The top three bacteria of SBIs were A. baumannii (35.8%, 57/159), K. pneumoniae (30.8%, 49/159), and S. maltophilia (6.3%, 10/159). The isolation rates of carbapenem-resistant A. baumannii and K. pneumoniae were 91.2 and 75.5%, respectively. Meticillin resistance was present in 100% of Staphylococcus aureus and Coagulase negative staphylococci, and vancomycin resistance was not found. Conclusions SBIs may occur in patients hospitalized with COVID-19 and lead to high mortality. The incidence of SBIs was associated with the severity of illness on admission. Gram-negative bacteria, especially A. baumannii and K. pneumoniae, were the main bacteria, and the resistance rates of the major isolated bacteria were generally high. This was a single-center study; thus, our results should be externally examined when applied in other institutions. |
| first_indexed | 2024-12-21T01:52:51Z |
| format | Article |
| id | doaj.art-273b348786344688bbab47ed61fc765f |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-21T01:52:51Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-273b348786344688bbab47ed61fc765f2022-12-21T19:19:51ZengBMCAntimicrobial Resistance and Infection Control2047-29942020-09-01911710.1186/s13756-020-00819-1Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysisJie Li0Junwei Wang1Yi Yang2Peishan Cai3Jingchao Cao4Xuefeng Cai5Yu Zhang6Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background A considerable proportion of patients hospitalized with coronavirus disease 2019 (COVID-19) acquired secondary bacterial infections (SBIs). The etiology and antimicrobial resistance of bacteria were reported and used to provide a theoretical basis for appropriate infection therapy. Methods This retrospective study reviewed electronic medical records of all the patients hospitalized with COVID-19 in the Wuhan Union Hospital between January 27 and March 17, 2020. According to the inclusion and exclusion criteria, patients who acquired SBIs were enrolled. Demographic, clinical course, etiology, and antimicrobial resistance data of the SBIs were collected. Outcomes were also compared between patients who were classified as severe and critical on admission. Results Among 1495 patients hospitalized with COVID-19, 102 (6.8%) patients had acquired SBIs, and almost half of them (49.0%, 50/102) died during hospitalization. Compared with severe patients, critical patients had a higher chance of SBIs. Among the 159 strains of bacteria isolated from the SBIs, 136 strains (85.5%) were Gram-negative bacteria. The top three bacteria of SBIs were A. baumannii (35.8%, 57/159), K. pneumoniae (30.8%, 49/159), and S. maltophilia (6.3%, 10/159). The isolation rates of carbapenem-resistant A. baumannii and K. pneumoniae were 91.2 and 75.5%, respectively. Meticillin resistance was present in 100% of Staphylococcus aureus and Coagulase negative staphylococci, and vancomycin resistance was not found. Conclusions SBIs may occur in patients hospitalized with COVID-19 and lead to high mortality. The incidence of SBIs was associated with the severity of illness on admission. Gram-negative bacteria, especially A. baumannii and K. pneumoniae, were the main bacteria, and the resistance rates of the major isolated bacteria were generally high. This was a single-center study; thus, our results should be externally examined when applied in other institutions.http://link.springer.com/article/10.1186/s13756-020-00819-1COVID-19Secondary bacterial infectionsEtiologyAntimicrobial resistanceRetrospective analysis |
| spellingShingle | Jie Li Junwei Wang Yi Yang Peishan Cai Jingchao Cao Xuefeng Cai Yu Zhang Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis Antimicrobial Resistance and Infection Control COVID-19 Secondary bacterial infections Etiology Antimicrobial resistance Retrospective analysis |
| title | Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis |
| title_full | Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis |
| title_fullStr | Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis |
| title_full_unstemmed | Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis |
| title_short | Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis |
| title_sort | etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with covid 19 in wuhan china a retrospective analysis |
| topic | COVID-19 Secondary bacterial infections Etiology Antimicrobial resistance Retrospective analysis |
| url | http://link.springer.com/article/10.1186/s13756-020-00819-1 |
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