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Review
. 2023 Jun 17;13(6):1408.
doi: 10.3390/life13061408.

The Dark Side of Nosocomial Infections in Critically Ill COVID-19 Patients

Carmelo Biondo  1 , Elena Ponzo  1 , Angelina Midiri  1 , Giuseppe Bernardo Ostone  1 , Giuseppe Mancuso  1
Affiliations
Review

The Dark Side of Nosocomial Infections in Critically Ill COVID-19 Patients

Carmelo Biondo et al. Life (Basel). .

Abstract

Coronavirus disease 2019 (COVID-19) is a potentially serious acute respiratory infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since the World Health Organization (WHO) declared COVID-19 a global pandemic, the virus has spread to more than 200 countries with more than 500 million cases and more than 6 million deaths reported globally. It has long been known that viral respiratory tract infections predispose patients to bacterial infections and that these co-infections often have an unfavourable clinical outcome. Moreover, nosocomial infections, also known as healthcare-associated infections (HAIs), are those infections that are absent at the time of admission and acquired after hospitalization. However, the impact of coinfections or secondary infections on the progression of COVID-19 disease and its lethal outcome is still debated. The aim of this review was to assess the literature on the incidence of bacterial co-infections and superinfections in patients with COVID-19. The review also highlights the importance of the rational use of antibiotics in patients with COVID-19 and the need to implement antimicrobial stewardship principles to prevent the transmission of drug-resistant organisms in healthcare settings. Finally, alternative antimicrobial agents to counter the emergence of multidrug-resistant bacteria causing healthcare-associated infections in COVID-19 patients will also be discussed.

Keywords: COVID-19; alternative strategies; co-infection; multidrug resistance; secondary infection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Most common nosocomial infections. The most common infections associated with healthcare facilities include bloodstream infections (BSIs), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), and ventilator-associated pneumonia (VAP). The most common pathogens causing nosocomial infections are also listed.
Figure 2
Figure 2
Secondary infections in critically ill patients hospitalised with COVID-19. The figure shows the impact of comorbidities on COVID-19 outcomes and how antibiotic overuse leads to the development of drug-resistant pathogens. It also shows alternative therapies that could be used against these drug-resistant pathogens.
See this image and copyright information in PMC

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