Prevalence and Antibiotic Resistance Profile of Secondary Bacterial Pneumonia and Bloodstream Infection Among Hospitalized COVID-19 Patients and Their Relation to Procalcitonin
Background and Objectives: in COVID-19 patients, secondary bacterial infections (SBIs) are a known complication of viral respiratory infections and are significantly associated with poorer outcomes.Our study aimed to determine the prevalence, clinical profile, antimicrobial resistance profile, and p...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Erbil Polytechnic University
2023-09-01
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| Series: | Polytechnic Journal |
| Subjects: | |
| Online Access: | https://polytechnic-journal.epu.edu.iq/home/vol13/iss1/8 |
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| Summary: | Background and Objectives: in COVID-19 patients, secondary bacterial infections (SBIs) are a known
complication of viral respiratory infections and are significantly associated with poorer outcomes.Our
study aimed to determine the prevalence, clinical profile, antimicrobial resistance profile, and patient
outcomes of secondary bacterial pneumonia and blood infections in COVID-19 hospitalized patients and
their correlation with procalcitonin (PCT) levels.Method: During 7 months’ study, 260 clinical samples
(blood and respiratory specimens) were collected from 130 hospitalized COVID-19 patients, of which 90
were from intensive care units (ICUs) and 40 from non-ICU departments, at six hospitals in Erbil city, Iraq.
All samples were applied for bacterial identification via traditional method, Vitek-2 compact system, and
molecular (PCR) detection. The antibiotic resistance profile was obtained via Vitek-2 compact system and
the Standard International Kirby-Bauer disc diffusion method. Finally, the inflammatory biomarkers (PCT,
C-reactive protein CRP, and WBC count) wereevaluated.Results: Among 130 patients, 64.16% were
positive for SBIs, of which 86.9% from the ICU and 13.1% from the non-ICU department. The most
prevalent isolates were gram-negative (77.7%) versus gram-positive (22.3%) bacteria. Klebsiella
pneumoniae, Acinetobacter baumannii, and coagulase-negative staphylococci were the predominant
isolates in both blood and respiratory specimen. There was an obvious relation between mortality rate
and SBIs in the studied patients, which reached 81%. Most of the isolated bacteria, especially ICU
isolates, were multidrug resistant. PCT increased in 79 (89.8%) of the patients with SBIs. The highest PCT
level was found in patients with bloodstream infection.Conclusion: There is a high prevalence of bacterial
superinfections in COVID-19 patients during hospitalization. Gram negative bacteria, especially Klebsiella
pneumoniaeand Acinetobacter baumanniiwere the main bacteria, and the antimicrobial resistance rates
against the major isolated bacteria were generally high. ThePCT level was positively associated with
secondary bacterial infection and patient outcome. |
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| ISSN: | 2707-7799 |