Bacterial Infections and Antibiotic Resistance Rates in SARS-CoV-2 PCR Positive Patients

Öz

Background: In this study, it was aimed to determine the distribution and antibiotic resistance rates of bacteria isolated from endotracheal aspirate (ETA), blood, catheter samples taken from COVID-19 patients admitted Adana City Training and Research Hospital. Material and method: Between April 1, 2020 and March 31, 2021, 254 patients PCR pozitive patients were included in the study. Blood, catheter and respiratory tract culture growths and antibiotic susceptibility test results were retrospectively analyzed from the microbiology laboratory database. Results: 433 bacterial growths were detected in clinical samples taken from 254 COVID PCR positive patients. Among the bacterial agents, Acinetobacter baumannii (.25.17%; n =109) was the most common pathogens, followed by Escherichia coli (.5.54% n =24) and Klebsiella pneumoniae (.5.31%; n =23). Conclusion: Avoiding unnecessary antibiotic use in COVID 19 patients is critical to prevent resistance development and increase culture sensitivity.

Anahtar Kelimeler

• SARS COV2
• COVİD 19
• ANTİBİYOTİK DİRENCİ,
• RT PCR

SARS-CoV-2 PCR Pozitif Hastalarda Bakteriyel Enfeksiyonlar ve Antibiyotik Direnci

Öz

Amaç ve kapsam: Bu çalışmada Adana Şehir Eğitim ve Araştırma Hastanesin’de yatan COVID-19 hastalarından alınan endotrakeal aspirat (ETA), kan, kateter, örneklerinden izole edilen bakterilerin dağılımını ve antibiyotik direnç oranlarının belirlenmesi amaçlandı. Materyal ve metod: 1 Nisan 2020 ile 31 Mart 2021 tarihleri arasında PCR testi pozitif olarak tesbit edilen 254 hasta çalışmaya dahil edildi. Hastalardan gönderilen kan, katater ve solunum yolu kültür sonuçları ve antibiyotik duyarlılık test sonuçları mikrobiyoloji laboratuvarı veri tabanından retrospektif olarak incelendi. Bulgular: 254 COVİD PCR pozitif hastadan alınan klinik örneklerde 433 bakteri üremesi saptandı. Bakteriyel etkenler arasında, Acinetobacter baumannii (%.25,17; n =109), ardından Esherichia coli (%.5,54 n =24) ve Klebsiella pneumoniae (%.5,31; n =23) en yaygın patojenler olarak tespit edildi Sonuç: COVİD 19 hastarında gereksiz antibiyotik kullanımından kaçınılması direnç gelişiminin önlenmesi ve kültür duyarlılığının artması için kritik öneme sahiptir.

Anahtar Kelimeler

• SARS COV-2
• COVİD 19
• RT PCR
• İKİNCİL BAKTERİYEL ENFEKSİYON
• ANTİBİYOTİK DRENCİ

Kaynakça

1. KAYNAKLAR 1. Morris DE, Cleary DW, Clarke SC. Secondary Bacterial Infections Associated with Influenza Pandemics. Front Microbiol. 2017;8:1041.
2. 2. Grasselli G, Cattaneo E, Florio G. Secondary infections in critically ill patients with COVID-19. Crit Care. 2021;25(1):317.
3. 3. Cox MJ, Loman N, Bogaert D, O'Grady J. Co-infections: potentially lethal and unexplored in COVID-19. Lancet Microbe. 2020;1(1):e11.
4. 4. Huttner BD, Catho G, Pano-Pardo JR, Pulcini C, Schouten J. COVID-19: don't neglect antimicrobial stewardship principles! Clin Microbiol Infect. 2020;26(7):808-10.
5. 5. https://hsgm.saglik.gov.tr/depo/kurumsal/plan-ve-faaliyetler/numune-alma-el-kitabi.pdf. [
6. 6. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
7. 7. https://www.eucast.org/clinical_breakpoints/. [
8. 8. Petruk G, Puthia M, Petrlova J, Samsudin F, Strömdahl AC, Cerps S, et al. SARS-CoV-2 spike protein binds to bacterial lipopolysaccharide and boosts proinflammatory activity. J Mol Cell Biol. 2020;12(12):916-32.

9. 9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):E32-E40.
10. 10. Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clinical Microbiology and Infection. 2021;27(1):83-8.
11. 11. Karataş M, Yaşar-Duman M, Tünger A, Çilli F, Aydemir Ş, Özenci V. Secondary bacterial infections and antimicrobial resistance in COVID-19: comparative evaluation of pre-pandemic and pandemic-era, a retrospective single center study. Ann Clin Microbiol Antimicrob. 2021;20(1):51.
12. 12. Li J, Wang J, Yang Y, Cai P, Cao J, Cai X, et al. Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis. Antimicrobial Resistance & Infection Control. 2020;9(1):1-7.
13. 13. Rouzé A, Martin-Loeches I, Povoa P, Makris D, Artigas A, Bouchereau M, et al. Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study. Intensive Care Med. 2021;47(2):188-98.
14. 14. Zhu NJ, Rawson TM, Mookerjee S, Price JR, Davies F, Otter J, et al. Changing Patterns of Bloodstream Infections in the Community and Acute Care Across 2 Coronavirus Disease 2019 Epidemic Waves: A Retrospective Analysis Using Data Linkage. Clinical Infectious Diseases. 2021.
15. 15. LeRose J, Sandhu A, Polistico J, Ellsworth J, Cranis M, Jabbo L, et al. The Impact of COVID-19 Response on Central Line Associated Bloodstream Infections and Blood Culture Contamination Rates at a Tertiary Care Center in Greater Detroit Area. Infection Control and Hospital Epidemiology. 2020:1-15.
16. 16. Rebold N, Alosaimy S, Morrisette T, Holger D, Lagnf AM, Ansari I, et al. Clinical Characteristics Associated with Bacterial Bloodstream Coinfection in COVID-19. Infectious Diseases and Therapy. 2022;11(3):1281-96.
17. 17. Cusumano JA, Dupper AC, Malik Y, Gavioli EM, Banga J, Berbel Caban A, et al. Staphylococcus aureus Bacteremia in Patients Infected With COVID-19: A Case Series. Open Forum Infectious Diseases. 2020;7(11). 18. Adalbert JR, Varshney K, Tobin R, Pajaro R. Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review. BMC Infectious Diseases. 2021;21(1):985.
18. 19. ÇAYCI YT, SEYFİ Z, VURAL DG, BİLGİN K, BİRİNCİ A. COVID-19 Tanısı Alan Hastaların Bakteriyel Kültür Örneklerindeki Üremelerin ve Antibiyotik Duyarlılıklarının İncelenmesi. Sağlık Bilimlerinde Değer.12(2):203-7.
19. 20. Rafat Z, Ramandi A, Khaki PA, Ansari S, Ghaderkhani S, Haidar H, et al. Fungal and bacterial co-infections of the respiratory tract among patients with COVID-19 hospitalized in intensive care units. Gene Rep. 2022;27:101588.