Takeaway
- Bacterial co-infection/co-colonisation was not common in patients with COVID-19 infection within 48 hours of hospital admission.
- However, the rate of gram-negative bacterial infection, especially Klebsiella pneumoniae and Escherichia coli, was higher during intensive care unit (ICU) stay.
Why this matters
- A better understanding of bacterial co-infection in patients with COVID-19 is crucial for effective antimicrobial stewardship.
Study design
- A retrospective cohort study of 254 patients with COVID-19 infection (age, >16 years) admitted to 7 ICUs in England up to May 2020.
- The proportion and type of organisms were identified at ≤48 and >48 hours following hospital admission, corresponding to community and hospital-acquired co-infections.
- Funding: NIHR Nottingham Biomedical Research Centre.
Key results
- Overall, co-infection/co-colonisation was identified in 83 (32.7%) patients from hospital admission to the end of ICU stay.
- Bacterial co-infection/co-colonisation was identified within 48 hours of admission in 14 (5.5%) patients
- Staphylococcus aureus (4 patients) and Streptococcus pneumoniae (2 patients) were common pathogens.
- The rate of gram-negative bacterial infection increased with length of stay (LOS) in ICU.
- Klebsiella pneumoniae (23 patients) and Escherichia coli (20 patients) identified as common pathogens.
- The rate of co-infection/co-colonisation at >48 hours after hospital admission was 27/1000 person-days (95% CI, 21.3-34.1).
- Patients with co-infection/co-colonisation vs those without were more likely to die in ICU (OR, 1.78; 95% CI, 1.03-3.08; P=.04) and had a longer hospital LOS (sub-HR for discharge from ICU, 0.53; 95% CI, 0.39-0.71; P<.001).
Limitations
- Retrospective design.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
