Prevalence of bacterial infections and antimicrobial resistance profile in hospitalized patients with COVID-19
DOI:
https://doi.org/10.17058/reci.v14i1.18336Keywords:
COVID-19, BACTERIAL INFECTIONS, BACTERIAL RESISTANCE, NOSOCOMIAL INFECTIONAbstract
Background and Objectives: bacterial resistance is an important public health problem worldwide and is related to the indiscriminate use of antimicrobials, limiting the available therapeutic options. The COVID-19 pandemic aggravated this scenario, since the lack of a standardized therapy led to a considerable increase in the prescription of these drugs. Therefore, we proposed to investigate the prevalence of bacterial infections and the profile of antimicrobial resistance in patients diagnosed with COVID-19 as well as to point out possible risk factors. Methods: a retrospective study based on the analysis of medical records of patients hospitalized with COVID-19 over the age of 18. Information such as age, gender, length of stay, hospitalization unit, bacterial species and resistance profile and previous use of antimicrobials by patients diagnosed with COVID-19 were collected and analyzed using Excel® 2016. Results: of the 268 patients with COVID-19, 162 had suspected bacterial infections, and 26 patients (9.7%) were confirmed from positive cultures. Furthermore, around 80% of these patients underwent empirical treatment with antimicrobials, the majority of whom were male and admitted to the Intensive Care Unit. A total of 32 bacterial isolates were recovered, of which 59.4% were resistant to at least one class of antimicrobials, with 21.8% being multidrug resistant. Conclusion: despite the low percentage found of patients with COVID-19 who had bacterial infections and of these 21.8% were by multidrug-resistant bacteria, the reinforcement in infection prevention policies and the adequate management in the release of antimicrobials is necessary to reduce the hospital dissemination rates of such bacteria.
Downloads
References
Rodrigues CR, Silva ACS, Luca FR et al. Infecção Primária Da Corrente Sanguínea: Um Olhar Diferente Na Assistência. Braz J Infect Dis. 2021 Jan;25:101079. Portuguese. doi: 10.1016/j.bjid.2020.101079.
Johns Hopkins Coronavirus Resource Center. 2022; Disponível em: https://coronavirus.jhu.edu/data/mortality.
Cachoni AC, Cadari MB,Vieira G et al. Mulinari-Santos. “Perfil De Segurança E Eficácia Clínica Da Azitromicina No Tratamento Da COVID-19: Revisão Da Literatura”. Archives Of Health Investigation. 2022 vol.11(2)p. 332-6, doi:10.21270/archi.v11i2.5780.
Lai CC, Shih TP, Ko WC et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.
Segala FV, Bavaro DF, Di Gennaro F et al. Impact of SARS-CoV-2 Epidemic on Antimicrobial Resistance: A Literature Review. Viruses. 2021 Oct 20;13(11):2110. doi: 10.3390/v13112110.
Agência nacional de vigilância sanitária. Nota técnica GVIMS/GGTES nº 07/2021, de 29 de Dezembro de 2021. Disponível em: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/notas-tecnicas/notas-tecnicas-vigentes/nota-tecnica-gvims-ggtes-no-07-2021-criterios-diagnosticos-das-infeccoes-relacionadas-a-assistencia-a-saude-iras-notificacao-nacional-obrigatoria-para-o-ano-de-2022/view.
Murray AK. The Novel Coronavirus COVID-19 Outbreak: Global Implications for Antimicrobial Resistance. Front Microbiol. 2020 May 13;11:1020. doi: 10.3389/fmicb.2020.01020.
Hardie KR. Antimicrobial resistance: the good, the bad, and the ugly. Emerg Top Life Sci. 2020 Sep 8;4(2):129-136. doi: 10.1042/ETLS20190194. PMID: 32463087.
Brazilian Committee on Antimicrobial Susceptibility Testing. BRCast [Internet]. BrCAST. 2020. Disponível em: http://brcast.org.br/documentos/
Brasil. Agência Nacional de Vigilância Sanitária - Microbiologia Clínica para o Controle de Infecção Relacionada à Assistência à Saúde. Módulo 4 : Procedimentos Laboratoriais: da requisição do exame à análise microbiológica e laudo final/Agência Nacional de Vigilância Sanitária, 2013– Brasília: ANVISA.
Lansbury L, Lim B, Baskaran V et al. Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect. 2020 Aug;81(2):266-275. doi: 10.1016/j.jinf.2020.05.046.
Pasero D, Cossu AP, Terragni P. Multi-Drug Resistance Bacterial Infections in Critically Ill Patients Admitted with COVID-19. Microorganisms. 2021 Aug 20;9(8):1773. doi: 10.3390/microorganisms9081773.
Organização Pan-Americana da Saúde. Desfechos De Saúde E Covid-19 Nas Américas: Diferenças De Sexo. OPAS; 2021. Disponível em: https://iris.paho.org/handle/10665.2/53602.
Souza, L; Randow, R; Siviero, P. Reflexões em tempos de COVID: diferenciais entre sexo e idade. Comunicação em Ciências da Saúde. 2020 v. 31, p. 75-83. Disponível em: www.escs.edu.br/revistacss
Silva, M.V.R., de Castro, M.V., Passos-Bueno, M.R. et al. Men are the main COVID-19 transmitters: behavior or biology? Discov Ment Health2, 1(2022). doi: 10.1007/s44192-022-00004-3
ZHANG H, et al. Risks and features of secondary infections in severe and critical ill COVID19 patients. Emerging Microbes & Infections, 2020; 9(1):1958 – 1964. doi: 10.1089/mdr.2020.0489
Li J, Wang J, Yang Y et al. Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis. Antimicrob Resist Infect Control. 2020 Sep 22;9(1):153. doi: 10.1186/s13756-020-00819-1
Karruli A, Boccia F, Gagliardi M et al. Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single Center Experience. Microb Drug Resist. 2021 Sep;27(9):1167-1175. doi: 10.1089/mdr.2020.0489.
Moradi N, Kazemi N, Ghaemi M et al. Frequency and antimicrobial resistance pattern of bacterial isolates from patients with COVID-19 in two hospitals of Zanjan. Iran J Microbiol. 2021 Dec;13(6):769-778. doi: 10.18502/ijm.v13i6.8078.
Ritter, A. G., Bartniski, A. A., Velasquez, P. A. G., Velasquez, L. G., & Zonta, F. do N. S.Colonização de pacientes críticos por bactérias Gram-negativas multirresistentes /Critical patients colonized by bacteria Multiresistant gram-negatives. Brazilian Journal of Development. 2022 8(1), 3650–3666. https://doi.org/10.34117/bjdv8n1-240
Menezes, M. Detecção de bactérias resistentes a antibióticos triplicou na pandemia. 2021. Disponível em: https://portal.fiocruz.br/noticia/deteccao-de-bacteriasresistentes-antibioticos-triplicou-na-pandemia.
Rawson TM, Wilson RC, Holmes A. Understanding the role of bacterial and fungal infection in COVID-19. Clin Microbiol Infect. 2021 Jan;27(1):9-11. doi: 10.1016/j.cmi.2020.09.025. Epub 2020 Oct 9. PMID: 32979569; PMCID: PMC7546203.
Bhat K A, Madi D, Bhat S et al. Profile of Secondary Bacterial and Fungal Infections in Hospitalized COVID-19 Patients in a Tertiary Care Centre. Infect Drug Resist. 2022 Sep 28;15:5705-5714. doi: 10.2147/IDR.S378221. PMID: 36196428; PMCID: PMC9527002.
Nori P, Cowman K, Chen V et al. Bacterial and fungal coinfections in COVID-19 patients hospitalized during the New York City pandemic surge. Infect Control Hosp Epidemiol. 2021 Jan;42(1):84-88. doi: 10.1017/ice.2020.368. Epub 2020 Jul 24. PMID: 32703320; PMCID: PMC7417979.
Sang L, Xi Y, Lin Z et al. Secondary infection in severe and critical COVID-19 patients in China: a multicenter retrospective study. Ann Palliat Med. 2021 Aug;10(8):8557-8570. doi: 10.21037/apm-21-833. Epub 2021 Aug 3. PMID: 34379989.
Malik SS, Mundra S. Increasing Consumption of Antibiotics during the COVID-19 Pandemic: Implications for Patient Health and Emerging Anti-Microbial Resistance. Antibiotics (Basel). 2022 Dec 28;12(1):45. doi: 10.3390/antibiotics12010045. PMID: 36671246; PMCID: PMC9855050.
Centers for disease control and prevention. COVID-19: U.S. Impact on Antimicrobial Resistance, Special Report 2022. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2022. Disponível em: https://www.cdc.gov/drugresistance/covid19.html.
Patel A, Emerick M, Cabunoc MK et al. Rapid Spread and Control of Multidrug-Resistant Gram-Negative Bacteria in COVID-19 Patient Care Units. Emerg Infect Dis. 2021 Apr;27(4):1234-1237. doi: 10.3201/eid2704.204036.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 THAIS KAISER, Jhully, Thayglerson, Evelyn Zanni, Ana Helena Croce
This work is licensed under a Creative Commons Attribution 4.0 International License.
The author must state that the paper is original (has not been published previously), not infringing any copyright or other ownership right involving third parties. Once the paper is submitted, the Journal reserves the right to make normative changes, such as spelling and grammar, in order to maintain the language standard, but respecting the author’s style. The published papers become ownership of RECI, considering that all the opinions expressed by the authors are their responsibility. Because we are an open access journal, we allow free use of articles in educational and scientific applications provided the source is cited under the Creative Commons CC-BY license.
