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  • Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship #MMPMID33140176
  • Rothe K; Feihl S; Schneider J; Wallnofer F; Wurst M; Lukas M; Treiber M; Lahmer T; Heim M; Dommasch M; Waschulzik B; Zink A; Querbach C; Busch DH; Schmid RM; Schneider G; Spinner CD
  • Eur J Clin Microbiol Infect Dis 2021[Apr]; 40 (4): 859-869 PMID33140176show ga
  • The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Bacterial co-infections are associated with unfavourable outcomes in respiratory viral infections; however, microbiological and antibiotic data related to COVID-19 are sparse. Adequate use of antibiotics in line with antibiotic stewardship (ABS) principles is warranted during the pandemic. We performed a retrospective study of clinical and microbiological characteristics of 140 COVID-19 patients admitted between February and April 2020 to a German University hospital, with a focus on bacterial co-infections and antimicrobial therapy. The final date of follow-up was 6 May 2020. Clinical data of 140 COVID-19 patients were recorded: The median age was 63.5 (range 17-99) years; 64% were males. According to the implemented local ABS guidelines, the most commonly used antibiotic regimen was ampicillin/sulbactam (41.5%) with a median duration of 6 (range 1-13) days. Urinary antigen tests for Legionella pneumophila and Streptococcus peumoniae were negative in all cases. In critically ill patients admitted to intensive care units (n = 50), co-infections with Enterobacterales (34.0%) and Aspergillus fumigatus (18.0%) were detected. Blood cultures collected at admission showed a diagnostic yield of 4.2%. Bacterial and fungal co-infections are rare in COVID-19 patients and are mainly prevalent in critically ill patients. Further studies are needed to assess the impact of antimicrobial therapy on therapeutic outcome in COVID-19 patients to prevent antimicrobial overuse. ABS guidelines could help in optimising the management of COVID-19. Investigation of microbial patterns of infectious complications in critically ill COVID-19 patients is also required.
  • |*Antimicrobial Stewardship[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Ampicillin/therapeutic use[MESH]
  • |Anti-Bacterial Agents/*therapeutic use[MESH]
  • |Antifungal Agents/therapeutic use[MESH]
  • |Aspergillosis/drug therapy/epidemiology[MESH]
  • |Azithromycin/therapeutic use[MESH]
  • |Bacterial Infections/drug therapy/*epidemiology[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Cohort Studies[MESH]
  • |Coinfection/epidemiology[MESH]
  • |Enterobacteriaceae Infections/drug therapy/epidemiology[MESH]
  • |Escherichia coli Infections/drug therapy/epidemiology[MESH]
  • |Female[MESH]
  • |Germany/epidemiology[MESH]
  • |Humans[MESH]
  • |Klebsiella Infections/drug therapy/epidemiology[MESH]
  • |Linezolid/therapeutic use[MESH]
  • |Male[MESH]
  • |Meropenem/therapeutic use[MESH]
  • |Middle Aged[MESH]
  • |Piperacillin, Tazobactam Drug Combination/therapeutic use[MESH]
  • |Practice Patterns, Physicians'/*statistics & numerical data[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Staphylococcal Infections/drug therapy/epidemiology[MESH]
  • |Streptococcal Infections/drug therapy/epidemiology[MESH]
  • |Sulbactam/therapeutic use[MESH]
  • |Vancomycin/therapeutic use[MESH]
  • |Young Adult[MESH]

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  • suck abstract from ncbi

    859 4.40 2021