Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study
Patients with severe COVID-19, especially those followed in the ICU, are at risk for developing bacterial and fungal superinfections. In this study, we aimed to describe the burden of hospital-acquired superinfections in a cohort of consecutive, severe COVID-19 patients hospitalized between February...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/11/1598 |
| _version_ | 1797466156663046144 |
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| author | Luca Caiazzo Chiara Temperoni Benedetta Canovari Oriana Simonetti Roberto Montalti Francesco Barchiesi |
| author_facet | Luca Caiazzo Chiara Temperoni Benedetta Canovari Oriana Simonetti Roberto Montalti Francesco Barchiesi |
| author_sort | Luca Caiazzo |
| collection | DOAJ |
| description | Patients with severe COVID-19, especially those followed in the ICU, are at risk for developing bacterial and fungal superinfections. In this study, we aimed to describe the burden of hospital-acquired superinfections in a cohort of consecutive, severe COVID-19 patients hospitalized between February and May 2021 in the intensive care unit (ICU) department of San Salvatore Hospital in Pesaro, Italy. Among 89 patients considered, 68 (76.4%) acquired a secondary infection during their ICU stay. A total of 46 cases of ventilator-associated pneumonia (VAP), 31 bloodstream infections (BSIs) and 15 catheter-associated urinary tract infections (CAUTIs) were diagnosed. Overall mortality during ICU stay was 48%. A multivariate analysis showed that factors independently associated with mortality were male gender (OR: 4.875, CI: 1.227–19.366, <i>p</i> = 0.024), higher BMI (OR: 4.938, CI:1.356–17.980, <i>p</i> = 0.015) and the presence of VAP (OR: 6.518, CI: 2.178–19.510, <i>p</i> = 0.001). Gram-negative bacteria accounted for most of the isolates (68.8%), followed by Gram-positive bacteria (25.8%) and fungi (5.3%). Over half of the infections (58%) were caused by MDR opportunistic pathogens. Factors that were independently associated with an increased risk of infections caused by an MDR pathogen were higher BMI (OR: 4.378, CI: 1.467–13.064, <i>p</i> = 0.0008) and a higher Charlson Comorbidity Index (OR: 3.451, 95% CI: 1.113–10.700, <i>p</i> = 0.032). Secondary infections represent a common and life-threatening complication in critically ill patients with COVID-19. Efforts to minimize the likelihood of acquiring such infections, often caused by difficult-to-treat MDR organisms—especially in some subgroups of patients with specific risk factors—must be pursued. |
| first_indexed | 2024-03-09T18:31:49Z |
| format | Article |
| id | doaj.art-fb066a2660f34bceb2d72c0e3f2e26e8 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T18:31:49Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-fb066a2660f34bceb2d72c0e3f2e26e82023-11-24T07:30:22ZengMDPI AGAntibiotics2079-63822022-11-011111159810.3390/antibiotics11111598Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective StudyLuca Caiazzo0Chiara Temperoni1Benedetta Canovari2Oriana Simonetti3Roberto Montalti4Francesco Barchiesi5Malattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, ItalyMalattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, ItalyMalattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, ItalyClinica Dermatologica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, 60126 Ancona, ItalyUnità di Chirurgia Epato-Bilio-Pancreatica, Mininvasiva e Robotica, Dipartimento di Sanità Pubblica, Università Federico II, 80131 Napoli, ItalyMalattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, ItalyPatients with severe COVID-19, especially those followed in the ICU, are at risk for developing bacterial and fungal superinfections. In this study, we aimed to describe the burden of hospital-acquired superinfections in a cohort of consecutive, severe COVID-19 patients hospitalized between February and May 2021 in the intensive care unit (ICU) department of San Salvatore Hospital in Pesaro, Italy. Among 89 patients considered, 68 (76.4%) acquired a secondary infection during their ICU stay. A total of 46 cases of ventilator-associated pneumonia (VAP), 31 bloodstream infections (BSIs) and 15 catheter-associated urinary tract infections (CAUTIs) were diagnosed. Overall mortality during ICU stay was 48%. A multivariate analysis showed that factors independently associated with mortality were male gender (OR: 4.875, CI: 1.227–19.366, <i>p</i> = 0.024), higher BMI (OR: 4.938, CI:1.356–17.980, <i>p</i> = 0.015) and the presence of VAP (OR: 6.518, CI: 2.178–19.510, <i>p</i> = 0.001). Gram-negative bacteria accounted for most of the isolates (68.8%), followed by Gram-positive bacteria (25.8%) and fungi (5.3%). Over half of the infections (58%) were caused by MDR opportunistic pathogens. Factors that were independently associated with an increased risk of infections caused by an MDR pathogen were higher BMI (OR: 4.378, CI: 1.467–13.064, <i>p</i> = 0.0008) and a higher Charlson Comorbidity Index (OR: 3.451, 95% CI: 1.113–10.700, <i>p</i> = 0.032). Secondary infections represent a common and life-threatening complication in critically ill patients with COVID-19. Efforts to minimize the likelihood of acquiring such infections, often caused by difficult-to-treat MDR organisms—especially in some subgroups of patients with specific risk factors—must be pursued.https://www.mdpi.com/2079-6382/11/11/1598COVID-19mechanical ventilationhospital-acquired infectionsresistance |
| spellingShingle | Luca Caiazzo Chiara Temperoni Benedetta Canovari Oriana Simonetti Roberto Montalti Francesco Barchiesi Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study Antibiotics COVID-19 mechanical ventilation hospital-acquired infections resistance |
| title | Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study |
| title_full | Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study |
| title_fullStr | Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study |
| title_full_unstemmed | Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study |
| title_short | Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study |
| title_sort | secondary infections in critically ill patients with covid 19 a retrospective study |
| topic | COVID-19 mechanical ventilation hospital-acquired infections resistance |
| url | https://www.mdpi.com/2079-6382/11/11/1598 |
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