Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran
Abstract Background The emergence of healthcare-associated infections (HAIs) or superinfections in COVID-19 patients has resulted in poor prognosis and increased mortality. Methods In a cross-sectional study, 101 respiratory samples were collected from ICU-admitted COVID-19 patients. The HAI rate, d...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01303-3 |
| _version_ | 1797577341001531392 |
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| author | Maryam Mobarak-Qamsari Bita Jenaghi Leyla Sahebi Mahsa Norouzi-Shadehi Mohammad-Reza Salehi Abbas Shakoori-Farahani Hoda Khoshnevis Alireza Abdollahi Mohammad-Mehdi Feizabadi |
| author_facet | Maryam Mobarak-Qamsari Bita Jenaghi Leyla Sahebi Mahsa Norouzi-Shadehi Mohammad-Reza Salehi Abbas Shakoori-Farahani Hoda Khoshnevis Alireza Abdollahi Mohammad-Mehdi Feizabadi |
| author_sort | Maryam Mobarak-Qamsari |
| collection | DOAJ |
| description | Abstract Background The emergence of healthcare-associated infections (HAIs) or superinfections in COVID-19 patients has resulted in poor prognosis and increased mortality. Methods In a cross-sectional study, 101 respiratory samples were collected from ICU-admitted COVID-19 patients. The HAI rate, demographics, and antibiotic resistance were assessed. Results The HAI rate was 83.16% (76.62% bacterial and 6.54% fungal). The prevalence of 3 major HAI-causing organisms included Klebsiella pneumoniae (41.5%), Acinetobacter baumannii (20.8%), and Staphylococcus aureus (4.9%). Mortality and intubation ventilation proportions of 90% (p = 0.027) and 92.2% (p = 0.02) were significant among patients with superinfection, respectively. Multiple logistic regression analysis showed SpO2 pressure (odds ratio 0.842; 95% CI 0.750–0.945; p = 0.004) as a predictive factor in the association between antibiotic usage and mortality. More than 50% of patients received carbapenems. The resistance rates to at least one antibiotic of third-generation cephalosporins, aminoglycosides, quinolones/fluoroquinolones, tetracyclines, and β-lactam inhibitors were 95.2%, 95.2%, 90%, 57.1%, and 100% among A. baumannii isolates and 71.4%, 55%, 69%, 61.9%, and 59.5% among K. pneumoniae isolates, respectively. A proportion of 60% was recorded for methicillin-resistant S. aureus isolates. Conclusion As a result, antibiotic treatment should be administered following the microbial resistance profile. Contact isolation and infection control measures should be implemented as needed. |
| first_indexed | 2024-03-10T22:06:52Z |
| format | Article |
| id | doaj.art-ee4ffe633d34478081e9458bfa9d7f73 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-10T22:06:52Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-ee4ffe633d34478081e9458bfa9d7f732023-11-19T12:47:19ZengBMCEuropean Journal of Medical Research2047-783X2023-09-0128111110.1186/s40001-023-01303-3Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, IranMaryam Mobarak-Qamsari0Bita Jenaghi1Leyla Sahebi2Mahsa Norouzi-Shadehi3Mohammad-Reza Salehi4Abbas Shakoori-Farahani5Hoda Khoshnevis6Alireza Abdollahi7Mohammad-Mehdi Feizabadi8Department of Microbiology, School of Medicine, Tehran University of Medical SciencesDepartment of Microbiology, School of Medicine, Tehran University of Medical SciencesFamily Health Research Institute. Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical SciencesDepartment of Infectious Disease, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical SciencesDepartment of Infectious Diseases, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical SciencesDepartment of Medical Genetics, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical SciencesImam Khomeini Hospital Complex, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical SciencesDepartment of Pathology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical SciencesDepartment of Microbiology, School of Medicine, Tehran University of Medical SciencesAbstract Background The emergence of healthcare-associated infections (HAIs) or superinfections in COVID-19 patients has resulted in poor prognosis and increased mortality. Methods In a cross-sectional study, 101 respiratory samples were collected from ICU-admitted COVID-19 patients. The HAI rate, demographics, and antibiotic resistance were assessed. Results The HAI rate was 83.16% (76.62% bacterial and 6.54% fungal). The prevalence of 3 major HAI-causing organisms included Klebsiella pneumoniae (41.5%), Acinetobacter baumannii (20.8%), and Staphylococcus aureus (4.9%). Mortality and intubation ventilation proportions of 90% (p = 0.027) and 92.2% (p = 0.02) were significant among patients with superinfection, respectively. Multiple logistic regression analysis showed SpO2 pressure (odds ratio 0.842; 95% CI 0.750–0.945; p = 0.004) as a predictive factor in the association between antibiotic usage and mortality. More than 50% of patients received carbapenems. The resistance rates to at least one antibiotic of third-generation cephalosporins, aminoglycosides, quinolones/fluoroquinolones, tetracyclines, and β-lactam inhibitors were 95.2%, 95.2%, 90%, 57.1%, and 100% among A. baumannii isolates and 71.4%, 55%, 69%, 61.9%, and 59.5% among K. pneumoniae isolates, respectively. A proportion of 60% was recorded for methicillin-resistant S. aureus isolates. Conclusion As a result, antibiotic treatment should be administered following the microbial resistance profile. Contact isolation and infection control measures should be implemented as needed.https://doi.org/10.1186/s40001-023-01303-3Healthcare-associated infectionsSuperinfectionCOVID-19Antibiotic resistanceRespiratory infections |
| spellingShingle | Maryam Mobarak-Qamsari Bita Jenaghi Leyla Sahebi Mahsa Norouzi-Shadehi Mohammad-Reza Salehi Abbas Shakoori-Farahani Hoda Khoshnevis Alireza Abdollahi Mohammad-Mehdi Feizabadi Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran European Journal of Medical Research Healthcare-associated infections Superinfection COVID-19 Antibiotic resistance Respiratory infections |
| title | Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran |
| title_full | Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran |
| title_fullStr | Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran |
| title_full_unstemmed | Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran |
| title_short | Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran |
| title_sort | evaluation of acinetobacter baumannii klebsiella pneumoniae and staphylococcus aureus respiratory tract superinfections among patients with covid 19 at a tertiary care hospital in tehran iran |
| topic | Healthcare-associated infections Superinfection COVID-19 Antibiotic resistance Respiratory infections |
| url | https://doi.org/10.1186/s40001-023-01303-3 |
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