Co-Infections in Critically Ill Patients with or without COVID-19: A Comparison of Clinical Microbial Culture Findings

Rosario Cultrera, Agostino Barozzi, Marco Libanore, Elisabetta Marangoni, Roberto Pora, Brunella Quarta, Savino Spadaro, Riccardo Ragazzi, Anna Marra, Daniela Segala and Carlo Alberto Volta
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Rosario Cultrera: Infectious Diseases, Department of Traslational Medicine, University of Ferrara, 44121 Ferrara, Italy
Agostino Barozzi: Clinical Microbiology, Department of Biotechnology, Transfusional and Laboratory, University Hospital of Ferrara, 44124 Ferrara, Italy
Marco Libanore: Infectious Diseases Unit, Department of Medicine, University Hospital of Ferrara, 44124 Ferrara, Italy
Elisabetta Marangoni: Intensive Care Unit, Department of Traslational Medicine, University of Ferrara, 44121 Ferrara, Italy
Roberto Pora: Clinical Microbiology, Department of Biotechnology, Transfusional and Laboratory, University Hospital of Ferrara, 44124 Ferrara, Italy
Brunella Quarta: Pharmacy Service, University Hospital of Ferrara, 44124 Ferrara, Italy
Savino Spadaro: Intensive Care Unit, Department of Traslational Medicine, University of Ferrara, 44121 Ferrara, Italy
Riccardo Ragazzi: Intensive Care Unit, Department of Traslational Medicine, University of Ferrara, 44121 Ferrara, Italy
Anna Marra: Pharmacy Service, University Hospital of Ferrara, 44124 Ferrara, Italy
Daniela Segala: Infectious Diseases, Department of Traslational Medicine, University of Ferrara, 44121 Ferrara, Italy
Carlo Alberto Volta: Intensive Care Unit, Department of Traslational Medicine, University of Ferrara, 44121 Ferrara, Italy

IJERPH, 2021, vol. 18, issue 8, 1-10

Abstract: Co-infections in critically ill patients hospitalized for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have an important impact on the outcome of coronavirus disease 2019 (COVID-19). We compared the microbial isolations found in COVID-19 patients hospitalized in an intensive care unit (ICU) with those in a non-COVID-19 ICU from 22 February to 30 April 2020 and in the same period of 2019. We considered blood, urine or respiratory specimens obtained with bronchoalveolar lavage (BAL) or bronchial aspirate (BASP), collected from all patients admitted in ICUs with or without COVID-19 infection. We found a higher frequency of infections due to methicillin-resistant (MR) staphylococci, vancomycin-resistant Enterococcus faecium , carbapenem-resistant Acinetobacter baumannii and Candida parapsilosis in COVID-19-positive patients admitted in ICUs compared to those who were COVID-19 negative. Carbapenem-resistant Pseudomonas aeruginosa was more frequently isolated from patients admitted in non-COVID-19 ICUs. Several conditions favor the increased frequency of these infections by antibiotic-resistant microorganisms. Among all, the severity of the respiratory tracts was definitely decisive, which required assisted ventilation with invasive procedures. The turnover in the ICU of a large number of patients in a very short time requiring urgent invasive interventions has favored the not always suitable execution of assistance procedures. No less important is the increased exposure to infectious risk from bacteria and fungi in patients with severe impairment due to ventilation. The highest costs for antifungal drugs were shown in the ICU-COVID group.

Keywords: SARS-CoV-2; COVID-19; co-infection; microbial culture; antimicrobial consumption; antimicrobial expenditure; intensive care unit (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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