Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients

The global spread of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has infected humans in all age groups, deteriorated host immune responses, and caused millions of deaths. The reasons for individuals succumbing to COVID-19 were not...

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Main Authors: Gul Habib, Khalid Mahmood, Haji Gul, Muhammad Tariq, Qurat Ul Ain, Azam Hayat, Mujaddad Ur Rehman
Format: Article
Jezik:English
Izdano: MDPI AG 2022-07-01
Serija:Pathophysiology
Teme:
Online dostop:https://www.mdpi.com/1873-149X/29/3/32
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author Gul Habib
Khalid Mahmood
Haji Gul
Muhammad Tariq
Qurat Ul Ain
Azam Hayat
Mujaddad Ur Rehman
author_facet Gul Habib
Khalid Mahmood
Haji Gul
Muhammad Tariq
Qurat Ul Ain
Azam Hayat
Mujaddad Ur Rehman
author_sort Gul Habib
collection DOAJ
description The global spread of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has infected humans in all age groups, deteriorated host immune responses, and caused millions of deaths. The reasons for individuals succumbing to COVID-19 were not only the SARS-CoV-2 infection but also associated bacterial infections. Antibiotics were largely used to prevent bacterial infections during COVID-19 illness, and many bacteria became resistant to conventional antibiotics. Although COVID-19 was considered the main culprit behind the millions of deaths, bacterial coinfections and superinfections were the major factors that increased the mortality rate in hospitalized patients. In the present study, we assessed the pathophysiology of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) superinfection in COVID-19 patients in Pakistan. A total of 3492 COVID-19 hospitalized patients were screened among which 224 strain were resistant to methicillin; 110 strains were tazobactam-resistant; 53 strains were ciprofloxacin-resistant; 23 strains were gentamicin-resistant; 11 strains were azithromycin-resistant; 3 strains were vancomycin-resistant. A high frequency of MRSA was detected in patients aged ≥50 with a prevalence of 7.33%, followed by patients aged >65 with a prevalence of 5.48% and a 5.10% prevalence in patients aged <50. In addition, pneumonia was detected in the COVID-19-associated MRSA (COVID-MRSA) that showed decreased levels of lymphocytes and albumin and increased the mortality rate from 2.3% to 25.23%. Collectively, an MRSA superinfection was associated with increased mortality in COVID-19 after 12 to 18 days of hospitalization. The study assessed the prevalence of MRSA, mortality rate, pneumonia, and the emergence of antibiotic resistance as the main outcomes. The study summarized that COVID-MRSA aggravated the treatment and recovery of patients and suggested testing MRSA as critical for hospitalized patients.
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spelling doaj.art-47ad39f1dd0e41f4b09237adcd25bdd82023-11-23T18:17:02ZengMDPI AGPathophysiology1873-149X2022-07-0129340541310.3390/pathophysiology29030032Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 PatientsGul Habib0Khalid Mahmood1Haji Gul2Muhammad Tariq3Qurat Ul Ain4Azam Hayat5Mujaddad Ur Rehman6Department of Microbiology, Abbottabad University of Science and Technology, Havelian, Abbottabad 22010, PakistanNational Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75850, PakistanCollege of Animal Science and Technology, Anhui Agricultural University, Hefei 230036, ChinaInstitute of Paramedical Sciences, Khyber Medical University, Peshawar 25000, PakistanDepartment of Microbiology, Abbottabad University of Science and Technology, Havelian, Abbottabad 22010, PakistanDepartment of Microbiology, Abbottabad University of Science and Technology, Havelian, Abbottabad 22010, PakistanDepartment of Microbiology, Abbottabad University of Science and Technology, Havelian, Abbottabad 22010, PakistanThe global spread of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has infected humans in all age groups, deteriorated host immune responses, and caused millions of deaths. The reasons for individuals succumbing to COVID-19 were not only the SARS-CoV-2 infection but also associated bacterial infections. Antibiotics were largely used to prevent bacterial infections during COVID-19 illness, and many bacteria became resistant to conventional antibiotics. Although COVID-19 was considered the main culprit behind the millions of deaths, bacterial coinfections and superinfections were the major factors that increased the mortality rate in hospitalized patients. In the present study, we assessed the pathophysiology of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) superinfection in COVID-19 patients in Pakistan. A total of 3492 COVID-19 hospitalized patients were screened among which 224 strain were resistant to methicillin; 110 strains were tazobactam-resistant; 53 strains were ciprofloxacin-resistant; 23 strains were gentamicin-resistant; 11 strains were azithromycin-resistant; 3 strains were vancomycin-resistant. A high frequency of MRSA was detected in patients aged ≥50 with a prevalence of 7.33%, followed by patients aged >65 with a prevalence of 5.48% and a 5.10% prevalence in patients aged <50. In addition, pneumonia was detected in the COVID-19-associated MRSA (COVID-MRSA) that showed decreased levels of lymphocytes and albumin and increased the mortality rate from 2.3% to 25.23%. Collectively, an MRSA superinfection was associated with increased mortality in COVID-19 after 12 to 18 days of hospitalization. The study assessed the prevalence of MRSA, mortality rate, pneumonia, and the emergence of antibiotic resistance as the main outcomes. The study summarized that COVID-MRSA aggravated the treatment and recovery of patients and suggested testing MRSA as critical for hospitalized patients.https://www.mdpi.com/1873-149X/29/3/32MRSACOVID-19<i>mecA</i>antibiotic resistancepneumonia
spellingShingle Gul Habib
Khalid Mahmood
Haji Gul
Muhammad Tariq
Qurat Ul Ain
Azam Hayat
Mujaddad Ur Rehman
Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients
Pathophysiology
MRSA
COVID-19
<i>mecA</i>
antibiotic resistance
pneumonia
title Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients
title_full Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients
title_fullStr Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients
title_full_unstemmed Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients
title_short Pathophysiology of Methicillin-Resistant <i>Staphylococcus aureus</i> Superinfection in COVID-19 Patients
title_sort pathophysiology of methicillin resistant i staphylococcus aureus i superinfection in covid 19 patients
topic MRSA
COVID-19
<i>mecA</i>
antibiotic resistance
pneumonia
url https://www.mdpi.com/1873-149X/29/3/32
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AT hajigul pathophysiologyofmethicillinresistantistaphylococcusaureusisuperinfectionincovid19patients
AT muhammadtariq pathophysiologyofmethicillinresistantistaphylococcusaureusisuperinfectionincovid19patients
AT quratulain pathophysiologyofmethicillinresistantistaphylococcusaureusisuperinfectionincovid19patients
AT azamhayat pathophysiologyofmethicillinresistantistaphylococcusaureusisuperinfectionincovid19patients
AT mujaddadurrehman pathophysiologyofmethicillinresistantistaphylococcusaureusisuperinfectionincovid19patients