Microbiological Analysis of Secondary Bacterial Infections in Patients Infected with the SARS-CoV-2 Virus

Year 2021, , 270 - 273, 01.09.2021

Melek Bilgin , Eşe Başbulut Hacer İşler Cemanur Aygün

https://doi.org/10.19127/bshealthscience.867150

Abstract

Accumulating evidence shows that secondary infection increases the risk of disease severity in respiratory diseases. There have been few studies about secondary infections among COVID-19 patients. Therefore we aimed to investigate prevalence, predisposing factors and causative organisms associated with COVID-19 secondary infection. This study was conducted at Training and Research Hospital in Samsun Turkey between March 15, 2020 and June 15, 2020. Hospitalized COVID-19 patients confirmed with Reverse Transcription Polymerase Chain Reaction (RT-PCR) were included in this study. Various clinical specimens (urine, sputum, endotracheal aspirate, blood etc.) of these patients have been sent to the microbiology laboratory were evaluated retrospectively. During the study period, 270 patients have been diagnosed COVID‐19 confirmed with PCR. The bacterial secondary infection rate among COVID-19 patients was 4% (11 of 270). The mortality rate among intensive care unit (ICU) patients with secondary infections was 80%. The most common secondary infection was urinary tract infection followed by bacteremia, and pneumonia. The most common isolated bacteria is Escherichia coli (E. coli) followed by coagulase-negative staphylococci (CoNS). Among COVID-19 patients, secondary infection may significantly inhibit the immune system of host and leads to significant morbidity and mortality. This is problematic and especially impacts patient clinical management, infection control, and antimicrobial stewardship programs. Therefore, further studies are needed to identify the possible pathogens and to evaluate the influence of secondary infections on the severity of SARS-CoV-2 infection.

Keywords

COVID-19, SARS CoV-2, Secondary infection

Project Number

This study was approved by the Ethics Commission of Samsun Training and Research Hospital 05.06.2020 2020/8/8.

References

• Blyth CC, Webb SA, Kok J, Dwyer DE, van Hal SJ, Foo H, Ginn AN, Kesson AM, Seppelt I, Iredell JR, ANZIC Influenza Investigators, & COSI Microbiological Investigators. 2013. The impact of bacterial and viral co-infection in severe influenza. Influenza Other Respir Viruses, 7(2): 168–176. https://doi.org/10.1111/j.1750-2659.2012.00360.x.
• Bosseboeuf E, Aubry M, Nhan T, Jean Jacques de Pina JJ, Rolain JM, Raoult D, Musso D. 2018. Azithromycin inhibits the replication of Zika virus. J Antivirals Antiretrovir, 10(1): 6-11. DOI: 10.4172/1948-5964.1000173.
• Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan China, a descriptive study. Lancet London England, 39510223: 507–513. https,//doi.org/10.1016/S0140-67362030211-7.
• Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, Li P, Zhou Y, Lin YF, Duan Q, Luo G, Fan S, Lu Y, Feng A, Zhan Y, Liang B, Cai W, Zhang L, Du X, Li L, Zou H. 2020. Clinical characteristics of coronavirus disease 2019 COVID-19 in China, A systematic review and meta-analysis. J Infect, 806: 656–665. https,//doi.org/10.1016/j.jinf.2020.03.041.
• Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, Satlin MJ, Campion TR, Jr Nahid M, Ringel JB, Hoffman KL, Alshak MN, Li HA, Wehmeyer GT, Rajan M, Reshetnyak E, Hupert N, Horn EM, Martinez FJ, Gulick RM, Safford MM. 2020. Clinical characteristics of Covid-19 in New York city. New England J Med, 38224: 2372–2374. https,//doi.org/10.1056/NEJMc2010419.
• He Y, Li W, Wang Z, Chen H, Tian L, Liu D. 2020. Nosocomial infection among patients with COVID-19, a retrospective data analysis of 918 cases from a single center in Wuhan China. Infect Control Hospital Epid, 418: 982–983. https,//doi.org/10.1017/ice.2020.126.
• Hendaus MA, Jomha FA. 2020. Covid-19 induced superimposed bacterial infectionJ of biomolecular structure dynamics 1–7Advance online publication. https,//doi.org/10.1080/07391102.2020.1772110 (accessed date July 10, 2020).
• Lai CC, Wang CY, Hsueh PR. 2020. Co-infections among patients with COVID-19, The need for combination therapy with non-anti-SARS-CoV-2 agents? J Microbiol Immun Infect, 534: 505–512. https,//doi.org/10.1016/j.jmii.2020.05.013.
• Lansbury L, Lim B, Baskaran V, Lim WS. 2020. Co-infections in people with COVID-19, a systematic review and meta-analysis. J Infect, 812: 266–275. https,//doi.org/10.1016/j.jinf.2020.05.046.
• Li XX, Zhou XN. 2013. Co-infection of tuberculosis and parasitic diseases in humans, a systematic review. Parasites Vectors, 6: 79. https,//doi.org/10.1186/1756-3305-6-79.
• Madrid PB, Panchal RG, Warren TK, Shurtleff AC, Endsley AN, Green CE, Kolokoltsov A, Davey R, Manger ID, Gilfillan L, Bavari S, Tanga MJ. 2015. Evaluation of Ebola Virus Inhibitors for Drug Repurposing. ACS Infect Diseases, 17: 317–326. https,//doi.org/10.1021/acsinfecdis.5b00030.
• Poschet JF, Perkett EA, Timmins GS, Deretic V. 2020. Azithromycin and ciprofloxacin have a chloroquine-like effect on respiratory epithelial cells. bioRxiv, 2020.03.29.008631. https,//doi.org/10.1101/2020.03.29.008631.
• Retallack H, Di Lullo E, Arias C, Knopp KA, Laurie MT, Sandoval-Espinosa C, Mancia Leon WR, Krencik R, Ullian EM, Spatazza J, Pollen AA, Mandel-Brehm C, Nowakowski TJ, Kriegstein AR, DeRisi JL. 2016. Zika virus cell tropism in the developing human brain and inhibition by azithromycin. Proceedings of the National Academy of Sciences of the United States of America, 11350: 14408–14413. https,//doi.org/10.1073/pnas.1618029113.
• Türkiye Sağlık Bakanlığı. 2020. https,//covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf?type=file (accessed date July 10, 2020).
• Wang L, He W, Yu X, Hu D, Bao M, Liu H, Zhou J, Jiang H. 2020. Coronavirus disease 2019 in elderly patients, characteristics and prognostic factors based on 4-week follow-up. J Infect, 806: 639–645. https,//doi.org/10.1016/j.jinf.2020.03.019.
• Wang Z, Yang B, Li Q, Wen L, Zhang R. 2020. Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan China. Infect Diseases Soc America, 7115: 769–777. https//doi.org/10.1093/cid/ciaa272.
• WHO.2020.https,//www.who.int/emergencies/diseases/novel-coronavirus-2019accessed 10 July 2020.
• Wu CP, Adhi F, Highland K. 2020. Recognition and management of respiratory coinfection and secondary bacterial pneumonia in patients with COVID-19. Cleve Clin J Med, 87: 11 659-663. https,//doi.org/10.3949/ccjm.87a.ccc015.
• Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan China, a retrospective cohort study. Lancet London England, 39510229: 1054–1062. https,//doi.org/10.1016/S0140-67362030566-3v.
• Zhu X, Ge Y, Wu T, Zhao K, Chen Y, Wu B, Zhu F, Zhu B, Cui L. 2020. Co-infection with respiratory pathogens among COVID-2019 cases. Virus Res, 285: 198005. https,//doi.org/10.1016/j.virusres.2020.198005.