A Case Report of Methicillin-Resistant Staph. aureus Coinfection in COVID-19 in the Intensive Care Unit

Year 2023, Volume: 5 Issue: 2, 145 - 149, 29.04.2023

Ijaz Ahmad Ibrar Khan Shahab Ahmad Khan Hayat Khan

https://doi.org/10.46310/tjim.1192956

Abstract

Bacterial co-infections in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia are not very common as the prevalence of co-infections with other respiratory viruses. The rate of bacterial co-infection in hospitalized patients infected with influenza is higher than 30%, whereas it is lower than 4% in hospitalized patients with SARS-CoV-2. Respiratory viral infections associated with bacterial co-infection have higher mortality and morbidity rates. The literature shows that most SARS-CoV-2 patients admitted to the hospital do not necessarily screen for bacterial infections and antimicrobial susceptibility. Therefore, clinicians' misdiagnosis of these co-infections can pose a significant risk to the lives of vulnerable patients with COVID-19. In that light, we presented a complicated case of methicillin-resistant Staphylococcus aureus.

Keywords

SARS-CoV-2, Bacterial Coinfection, MRSA, Covid-19

References

• Santos P, Gonçalves C, Oliveira C, Queiroz P, Ito CRM, Santos O, Carneiro C. Bacterial co-infection in patients with COVID-19 hospitalized (ICU and not ICU): Review and meta-analysis. Antibiotics (Basel). 2022 Jul; 11(7):894. doi: 10.3390/antibiotics11070894.
• Prasso E, Deng C. Postviral complications: bacterial pneumonia. Clin Chest Med. 2017 Mar;38(1):127-38. doi: 10.1016/j.ccm.2016.11.006.
• Shah S, Karlapalem C, Patel P, Madan N. Streptococcus pneumoniae Coinfection in COVID-19 in intensive care Unit: A Series of Four Cases. Case Rep Crit Care. 2022 Aug;12(8):144942. doi: 10.1155/2022/8144942.
• Morens M, Taubenberger K, Fauci S. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis. 2008 Oct;198(7):962-70. doi: 10.1086/591708.
• Martín-Loeches I, Sanchez-Corral A, Diaz E, Granada M, Zaragoza R, Villavicencio C, Albaya A, Cerdá E, Catalán M, Luque P, Paredes A, Navarrete I, Rello J, Rodríguez A; H1N1 SEMICYUC working group. Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus. Chest. 2011 Mar;139(3):555-62. doi: 10.1378/chest.10-1396.
• Wu Z, McGoogan M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr;323(13):1239-42. doi: 10.1001/jama.2020.2648.
• 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. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3.
• Khilnani GC, Zirpe K, Hadda V, Mehta Y, Madan K, Kulkarni A, Mohan A, Dixit S, Guleria R, Bhattacharya P. Guidelines for antibiotic prescription in intensive care unit. Indian J Crit Care Med. 2019 Jan;23(Suppl 1):S1-S63. doi: 10.5005/jp-journals-10071-23101.
• Liu Y, Ling L, Wong SH, Wang MH, Fitzgerald JR, Zou X, Fang S, Liu X, Wang X, Hu W, Chan H, Wang Y, Huang D, Li Q, Wong WT, Choi G, Zou H, Hui DS, Yu J, Tse G, Gin T, Wu WK, Chan MT, Zhang L. Outcomes of respiratory viral-bacterial co-infection in adult hospitalized patients. EClinicalMedicine. 2021 Jun 10;37:100955. doi: 10.1016/j.eclinm.2021.100955.
• Pacheco GA, Gálvez NMS, Soto JA, Andrade CA, Kalergis AM. Bacterial and viral coinfections with the human respiratory syncytial virus. Microorganisms. 2021 Jun 13;9(6):1293. doi: 10.3390/microorganisms9061293.
• Khan SA, Ahmad I, Khan W, Khan H, Akbar S. The contagious nature of SARS-CoV-2 omicron variant and vaccine efficacy. Adv Life Sci. 2022 Dec;9(4):429-36.
• Lai C, Wang Y, Hsueh R. Co-infections among patients with COVID-19: The need for combination therapy with non-anti-SARS-CoV-2 agents? J Microbiol Immunol Infect. 2020 Aug;53(4):505-12. doi: 10.1016/j.jmii.2020.05.013.
• Adalbert JR, Varshney K, Tobin R, Pajaro R. Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review. BMC Infect Dis. 2021 Sep;21(1):985. doi: 10.1186/s12879-021-06616-4.
• Morris E, Cleary W, Clarke C. Secondary bacterial infections associated with influenza pandemics. Front Microbiol. 2017 Jun;8:1041. doi: 10.3389/fmicb.2017.01041.
• Cercenado E, Marín M, Burillo A, Martín-Rabadán P, Rivera M, Bouza E. Rapid detection of Staphylococcus aureus in lower respiratory tract secretions from patients with suspected ventilator-associated pneumonia: evaluation of the Cepheid Xpert MRSA/SA SSTI assay. J Clin Microbiol. 2012 Dec;50(12):4095-7. doi: 10.1128/JCM.02409-12.