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. 2023 Apr 19;12(4):620.
doi: 10.3390/pathogens12040620.

A Retrospective Assessment of Sputum Samples and Antimicrobial Resistance in COVID-19 Patients

Talida Georgiana Cut  1   2   3   4 , Adelina Mavrea  5 , Alin Adrian Cumpanas  6 , Dorin Novacescu  2   4 , Cristian Iulian Oancea  7   8 , Felix Bratosin  1   2 , Adelina Raluca Marinescu  1 , Ruxandra Laza  1 , Alexandra Mocanu  1   2 , Alexandru Silvius Pescariu  4   5 , Diana Manolescu  9 , Raluca Dumache  3   10 , Alexandra Enache  3   10 , Elena Hogea  11 , Voichita Elena Lazureanu  1
Affiliations

A Retrospective Assessment of Sputum Samples and Antimicrobial Resistance in COVID-19 Patients

Talida Georgiana Cut et al. Pathogens. .

Abstract

Data on bacterial or fungal pathogens and their impact on the mortality rates of Western Romanian COVID-19 patients are scarce. As a result, the purpose of this research was to determine the prevalence of bacterial and fungal co- and superinfections in Western Romanian adults with COVID-19, hospitalized in in-ward settings during the second half of the pandemic, and its distribution according to sociodemographic and clinical conditions. The unicentric retrospective observational study was conducted on 407 eligible patients. Expectorate sputum was selected as the sampling technique followed by routine microbiological investigations. A total of 31.5% of samples tested positive for Pseudomonas aeruginosa, followed by 26.2% having co-infections with Klebsiella pneumoniae among patients admitted with COVID-19. The third most common Pathogenic bacteria identified in the sputum samples was Escherichia coli, followed by Acinetobacter baumannii in 9.3% of samples. Commensal human pathogens caused respiratory infections in 67 patients, the most prevalent being Streptococcus penumoniae, followed by methicillin-sensitive and methicillin-resistant Staphylococcus aureus. A total of 53.4% of sputum samples tested positive for Candida spp., followed by 41.1% of samples with Aspergillus spp. growth. The three groups with positive microbial growth on sputum cultures had an equally proportional distribution of patients admitted to the ICU, with an average of 30%, compared with only 17.3% among hospitalized COVID-19 patients with negative sputum cultures (p = 0.003). More than 80% of all positive samples showed multidrug resistance. The high prevalence of bacterial and fungal co-infections and superinfections in COVID-19 patients mandates for strict and effective antimicrobial stewardship and infection control policies.

Keywords: SARS-CoV-2; co-infection; multidrug resistance; outcome; superinfection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of Pathogenic bacteria identified in the sputum samples of hospitalized COVID-19 patients.
Figure 2
Figure 2
Distribution of commensal human pathogens identified in the sputum samples of hospitalized COVID-19 patients.
Figure 3
Figure 3
Distribution of fungi identified in the sputum samples of hospitalized COVID-19 patients.
Figure 4
Figure 4
Kaplan–Meier probability curve of patients’ survival stratified by antimicrobial resistance status.
Figure 5
Figure 5
Kaplan–Meier probability curve of patients’ survival stratified by sputum culture results.
See this image and copyright information in PMC

References

    1. Liang S.T., Liang L.T., Rosen J.M. COVID-19: A Comparison to the 1918 Influenza and How We Can Defeat It. Postgrad. Med. J. 2021;97:273–274. doi: 10.1136/postgradmedj-2020-139070. - DOI - PMC - PubMed
    1. Antimicrobial Resistance in the Age of COVID-19. Nat. Microbiol. 2020;5:779. doi: 10.1038/s41564-020-0739-4. - DOI - PubMed
    1. Kariyawasam R.M., Julien D.A., Jelinski D.C., Larose S.L., Rennert-May E., Conly J.M., Dingle T.C., Chen J.Z., Tyrrell G.J., Ronksley P.E., et al. Antimicrobial Resistance (AMR) in COVID-19 Patients: A Systematic Review and Meta-Analysis (November 2019–June 2021) Antimicrob. Resist. Infect. Control. 2022;11:45. doi: 10.1186/s13756-022-01085-z. - DOI - PMC - PubMed
    1. Rotondo J.C., Martini F., Maritati M., Caselli E., Gallenga C.E., Guarino M., De Giorgio R., Mazziotta C., Tramarin M.L., Badiale G., et al. Advanced Molecular and Immunological Diagnostic Methods to Detect SARS-CoV-2 Infection. Microorganisms. 2022;10:1193. doi: 10.3390/microorganisms10061193. - DOI - PMC - PubMed
    1. Biancolella M., Colona V.L., Mehrian-Shai R., Watt J.L., Luzzatto L., Novelli G., Reichardt J.K.V. COVID-19 2022 Update: Transition of the Pandemic to the Endemic Phase. Hum. Genom. 2022;16:19. doi: 10.1186/s40246-022-00392-1. - DOI - PMC - PubMed