Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU

Introduction: COVID-19 and secondary infections developing during COVID-19 follow-up are one of the most important causes of morbidity and mortality in intensive care units (ICU). In this study, we aimed to determine the frequency, microbiology, risk factors, and outcomes of secondary bacterial pne...

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Main Authors: Insa Gül Ekiz Iscanli, Mehtap Aydin, Bengü Şaylan
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-10-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/17066
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author Insa Gül Ekiz Iscanli
Mehtap Aydin
Bengü Şaylan
author_facet Insa Gül Ekiz Iscanli
Mehtap Aydin
Bengü Şaylan
author_sort Insa Gül Ekiz Iscanli
collection DOAJ
description Introduction: COVID-19 and secondary infections developing during COVID-19 follow-up are one of the most important causes of morbidity and mortality in intensive care units (ICU). In this study, we aimed to determine the frequency, microbiology, risk factors, and outcomes of secondary bacterial pneumonia in hospitalized patients due to COVID-19. Methodology: We studied all patients with bacterial pneumonia developed in patients with severe COVID-19 infection in the COVID-19 intensive care unit in a single-center hospital between March 16, 2020 and June 17, 2020. Patients hospitalized and followed up in the ICU for respiratory failure were examined in terms of secondary infection affecting morbidity and mortality. Results: Ninety-six (20%) of 471 patients had secondary bacterial pneumonia, respectively; of the leading pathogens were Acinetobacter baumannii (44.8%) and Klebsiella pneumoniae (39.6%), followed by Pseudomonas aeruginosa (4.2%), Escherichia coli (3.1%), methicillin-resistant Staphylococcus aureus (MRSA) (3.1%), Streptococcus pneumoniae (3.1%), and Methicillin-susceptible Staphylococcus aureus (MSSA) (1%). The mortality rate among infected (75% / 47.5%) was significantly higher than in uninfected patients. Associated with the development of secondary bacterial pneumonia in COVID-19 patients; corticosteroid therapy [odds ratio (OR) 6250, 95% confidence interval (CI) 1.383-28.571, p = 0.017), corticosteroid dose (OR 8.862 CI 2.299-70.258, p= 0.006), duration of mechanical ventilation (OR 1.199 CI) 1.088-1.322, p< 0.001). Conclusions: Secondary bacterial pneumonia was found to be associated with the severity and survival of the disease in patients admitted to ICU due to COVID-19. Duration of mechanical ventilation and use of corticosteroids and high-dose corticosteroids are risk factors for secondary bacterial pneumonia.
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spelling doaj-art-c20e6b0f355a44a3a9f49e4d1e061da22025-08-20T02:57:21ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-10-01171010.3855/jidc.17066Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICUInsa Gül Ekiz Iscanli0Mehtap Aydin1Bengü Şaylan2Department of Respiratory Intensive Care Unit, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Health Sciences University Umraniye Training and Research Hospital, University of Health Science, Istanbul, TurkeyDepartment of Pulmonology, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, University of Health Science, Istanbul, Turkey Introduction: COVID-19 and secondary infections developing during COVID-19 follow-up are one of the most important causes of morbidity and mortality in intensive care units (ICU). In this study, we aimed to determine the frequency, microbiology, risk factors, and outcomes of secondary bacterial pneumonia in hospitalized patients due to COVID-19. Methodology: We studied all patients with bacterial pneumonia developed in patients with severe COVID-19 infection in the COVID-19 intensive care unit in a single-center hospital between March 16, 2020 and June 17, 2020. Patients hospitalized and followed up in the ICU for respiratory failure were examined in terms of secondary infection affecting morbidity and mortality. Results: Ninety-six (20%) of 471 patients had secondary bacterial pneumonia, respectively; of the leading pathogens were Acinetobacter baumannii (44.8%) and Klebsiella pneumoniae (39.6%), followed by Pseudomonas aeruginosa (4.2%), Escherichia coli (3.1%), methicillin-resistant Staphylococcus aureus (MRSA) (3.1%), Streptococcus pneumoniae (3.1%), and Methicillin-susceptible Staphylococcus aureus (MSSA) (1%). The mortality rate among infected (75% / 47.5%) was significantly higher than in uninfected patients. Associated with the development of secondary bacterial pneumonia in COVID-19 patients; corticosteroid therapy [odds ratio (OR) 6250, 95% confidence interval (CI) 1.383-28.571, p = 0.017), corticosteroid dose (OR 8.862 CI 2.299-70.258, p= 0.006), duration of mechanical ventilation (OR 1.199 CI) 1.088-1.322, p< 0.001). Conclusions: Secondary bacterial pneumonia was found to be associated with the severity and survival of the disease in patients admitted to ICU due to COVID-19. Duration of mechanical ventilation and use of corticosteroids and high-dose corticosteroids are risk factors for secondary bacterial pneumonia. https://jidc.org/index.php/journal/article/view/17066Bacterial infectionsco-infectionCOVID-19K. pneumonia
spellingShingle Insa Gül Ekiz Iscanli
Mehtap Aydin
Bengü Şaylan
Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU
Journal of Infection in Developing Countries
Bacterial infections
co-infection
COVID-19
K. pneumonia
title Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU
title_full Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU
title_fullStr Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU
title_full_unstemmed Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU
title_short Clinical characteristics and risk factors associated with secondary bacterial pneumonia among COVID-19 patients in ICU
title_sort clinical characteristics and risk factors associated with secondary bacterial pneumonia among covid 19 patients in icu
topic Bacterial infections
co-infection
COVID-19
K. pneumonia
url https://jidc.org/index.php/journal/article/view/17066
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AT bengusaylan clinicalcharacteristicsandriskfactorsassociatedwithsecondarybacterialpneumoniaamongcovid19patientsinicu