Bacterial coinfections and secondary infections in COVID-19 patients from a tertiary care hospital of northern India: Time to adhere to culture-based practices.

Abstract

OBJECTIVE:

Bacterial co-pathogens are common in various viral respiratory tract infections, leading to increased disease severity and mortality. Still, they are understudied during large outbreaks and pandemics. This study was conducted to highlight the overall burden of these infections in COVID-19 patients admitted to our tertiary care hospital, along with their antibiotic susceptibility patterns.

MATERIAL AND METHODS:

During the six-month study period, clinical samples (blood samples, respiratory samples, and sterile body fluids, including cerebrospinal fluid [CSF]) of COVID-19 patients with suspected bacterial coinfections (at presentation) or secondary infections (after 48 hours of hospitalization) were received and processed for the same.

RESULTS:

Clinical samples of 814 COVID-19 patients were received for bacterial culture and susceptibility. Out of the total patient sample, 75% had already received empirical antibiotics before the samples were sent for analysis. Overall, 17.9% of cultures were positive for bacterial infections. Out of the total patients with bacterial infection, 74% (108/146) of patients had secondary bacterial infections (after 48 hours of hospitalization) and 26% (38/146) had bacterial coinfections (at the time of admission). Out of the 143 total isolates obtained, the majority (86%) were gram-negative organisms, of which Acinetobacter species was the commonest organism (35.6%), followed by Klebsiella pneumoniae (18.1%). The majority (50.7%) of the pathogenic organisms reported were multidrug resistant.

CONCLUSION:

The overall rate of secondary bacterial infections (SBIs) in our study was lower (7.9%) than reported by other studies. A rational approach would be to adhere to the practice of initiating culture-based guidance for antibiotics and to restrict unnecessary empirical antimicrobial therapy.

• Authors: Bhawna Sharma, Priya Sreenivasan, Manisha Biswal, Varun Mahajan, Vikas Suri, Inderpaul Singh Sehgal, Pallab Ray, Goverdhan Dutt Puri, Ashish Bhalla, Lakshmi Narayana Yaddanapudi, Vipin Koushal, Archana Angrup
• Journal: Qatar medical journal (Qatar Med J) Vol. 2021 Issue 3 Pg. 62 ( 2021) ISSN: 0253-8253 [Print] Qatar
• PMID: 34745914 (Publication Type: Journal Article)
• Copyright: © 2021 Sharma, Sreenivasan, Biswal, Mahajan, Suri, Sehgal, Ray, Puri, Bhalla, Yaddanapudi, Koushal, Angrup, licensee HBKU Press.