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Observational Study
. 2022 Jun;52(4):208-213.
doi: 10.1016/j.idnow.2021.12.001. Epub 2021 Dec 9.

Pulmonary bacterial infections in adult patients hospitalized for COVID-19 in standard wards

M Husain  1 , S Valayer  2 , N Poey  3 , E Rondinaud  4 , C d'Humières  4 , B Visseaux  5 , S Lariven  6 , F X Lescure  6 , L Deconinck  6
Affiliations
Observational Study

Pulmonary bacterial infections in adult patients hospitalized for COVID-19 in standard wards

M Husain et al. Infect Dis Now. 2022 Jun.

Abstract

Objectives: During the COVID-19 pandemic, antibiotic use was very common. However, bacterial co-/secondary infections with coronaviruses remain largely unknown in standard wards. We aimed to investigate the characteristics of pulmonary bacterial infections associated with COVID-19 in hospitalized patients.

Methods: A retrospective monocentric observational study was conducted in Bichat hospital, France, between February 26 and April 22, 2020. All patients hospitalized in standard wards with COVID-19 (positive nasopharyngeal PCR and/or typical aspect on CT-scan) and diagnosed with pulmonary bacterial infection (positive bacteriological samples) were included. Bacteriological and clinical data were collected from the microbiology laboratories and patient's medical records.

Results: Twenty-three bacteriological samples from 22 patients were positive out of 2075 screened samples (1.1%) from 784 patients (2.8%). Bacterial infection occurred within a median of 10 days after COVID-19 onset. Diagnosis of pulmonary bacterial infection was suspected on increase of oxygen requirements (20/22), productive cough or modification of sputum aspect (17/22), or fever (10/22). Positive samples included 13 sputum cultures, one FilmArray® assay on sputum samples, one bronchoalveolar lavage, six blood cultures, and two pneumococcal urinary antigen tests. The most frequent bacteria were Pseudomonas aeruginosa (6/23), Staphylococcus aureus (5/23), Streptococcus pneumoniae (4/23), Enterococcus faecalis (3/23), and Klebsiella aerogenes (3/23). No Legionella urinary antigen test was positive. Four out of 496 nasopharyngeal PCR tests (0.8%) were positive for intracellular bacteria (two Bordetella pertussis and two Mycoplasma pneumonia).

Conclusions: Pulmonary bacterial secondary infections and co-infections with SARS-CoV-2 are uncommon. Antibiotic use should remain limited in the management of COVID-19.

Keywords: Bacterial infection; Co-infection; Pneumonia; SARS-CoV-2; Secondary infection.

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Figures

Fig. 1
Fig. 1
Flow chart of bacteriological samples. BAL: bronchoalveolar lavage.
Fig. 2
Fig. 2
Variation of polynuclear neutrophils count (A) and CRP levels (B) before (J-X), at the onset (J0) and after (J + X) secondary bacterial infection.
Fig. 3
Fig. 3
Flow chart of bacterial multiplex PCR on nasopharyngeal swabs.
See this image and copyright information in PMC

References

    1. Al-Tawfiq J.A., Zumla A., Gautret P., Gray G.C., Hui D.S., Al-Rabeeah A.A., et al. Vol. 14. The Lancet Infectious Diseases. Lancet Publishing Group; 2014. pp. 992–1000. (Surveillance for emerging respiratory viruses). - PMC - PubMed
    1. Yin Y., Wunderink R.G. Vol. 23. Respirology. Blackwell Publishing; 2018. pp. 130–137. (MERS, SARS and other coronaviruses as causes of pneumonia). - PMC - PubMed
    1. Short K.R., Kedzierska K., van de Sandt C.E. Back to the future: lessons learned from the 1918 influenza pandemic. Front Cell Infect Microbiol. 2018;8:343. - PMC - PubMed
    1. Khandaker G., Dierig A., Rashid H., King C., Heron L., Booy R. Vol. 5. Influenza and other Respiratory Viruses. Wiley-Blackwell; 2011. pp. 148–156. (Systematic review of clinical and epidemiological features of the pandemic influenza A (H1N1) 2009). - PMC - PubMed
    1. Martín-Loeches I., Sanchez-Corral A., Diaz E., Granada R.M., Zaragoza R., Villavicencio C., et al. Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 Influenza A(H1N1) virus. CHEST. 2011;139(3):555–562. - PubMed

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