Study of Bacteria Isolated from COVID-19 and Non-COVID-19 Intensive Care Units and Determination of Their Antibiotic Susceptibility Profiles

Year 2022, Volume: 39 Issue: 4, 1027 - 1031, 29.10.2022

Çetin Kılınç , Nilay Coplu , Melike Yaşar Duman , Büşra Çalışır , Enis Fuat Tüfekci , Muhammet Gülhan , Ayşe Yılmaz , Veysel Garani Soylu

Abstract

Nosocomial infections are infections that occur 48-72 hours after hospitalization, especially caused by bacteria, and pose a high risk for patients in the intensive care units (ICUs), including Covid-ICU. This study was aimed to reveal the distribution and antibiotic susceptibility profiles of bacteria isolated from various clinical samples of non-Covid-ICU and Covid-ICU patients. Bacterial strains isolated from ICUs patients in Kastamonu Training and Research Hospital between March 2020 and October 2020 were included in this study. The identification of the strains was carried out using the Vitek 2 compact automated system (BioMerieux, France) as well as standard microbiological methods. Antibiotic susceptibility tests were studied using the Vitek 2 automated system and the results were interpreted based on the European Committee for Antimicrobial Susceptibility Tests (EUCAST) guideline. There were 302 patients in the non-Covid-ICU and 440 patients in the Covid-ICU. A total of 470 strains, 370 from non-Covid-ICU and 100 from Covid-ICU, were isolated. Acinetobacter spp was the most frequently isolated species for both ICUs. Acinetobacter spp isolated from non-Covid-ICU had higher resistance rates to meropenem (p= 0.043), ceftazidime (p= 0.014), and levofloxacin (p= <0.001) antibiotics than strains from Covid-ICU. Antibiotic susceptibility profiles of other strains were similar for both ICUs. As a result, the incidence of nosocomial infections in Covid-ICU patients was lower than in non-Covid-ICUs patients. Health personnel working in Covid-ICU may have played an important role in this, as they were more careful about using personal protective equipment and complying with hygiene rules. However, antibiotic resistance continues to be a serious problem in ICUs, including Covid-ICU.

Keywords

Acinetobacter, antibiotic resistance, Covid-intensive care unit, nosocomial infections

References

• 1. He F, Deng Y, Li W. Coronavirus disease 2019: What we know? J Med Virol. 2020; 92(7): 719–725.
• 2. Wu Z, McGoogan JM. 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; 323(13): 1239–1242.
• 3. Monegro AF, Muppidi V, Regunath H. Hospital acquired infections. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441857/
• 4. Manna S, Baindara P, Mandal SM. Molecular pathogenesis of secondary bacterial infection associated to viral infections including SARS-CoV-2. J Infect Public Health. 2020; 13(10): 1397–1404.
• 5. Obata R, Maeda T, Rizk D, Kuno T. Increased secondary infection in COVID-19 patients treated with steroids in New York City. Jpn J Infect Dis. 2021; 74(4): 307–315.
• 6. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, version 10.0, 2020. Available from: http://www.eucast.org/clinical_breakpoints/
• 7. Bulut ME, Öncül A. Nosocomial infection agents of Şişli Hamidiye Etfal training and research hospital: Comparison of 1995 and 2017 data. Med Bull Sisli Etfal Hosp 2020; 54(1): 78–82.
• 8. Genç Y, Gürkan Y, Mumcuoğlu İ, Kanyılmaz D, Aksoy A, Aksu N. Yoğun bakım hastalarında hastane kaynaklı pnömoni olgularının değerlendirilmesi ve sık görülen bakteriyel etkenlerin antimikrobiyallere dirençlerinin araştırılması. Turk Hij Den Biyol Derg. 2016; 73(4): 355–364.
• 9. Barış A, Bulut ME, Öncül A, Bayraktar B. Yoğun bakım ünitelerinde yatan hastalara ait klinik izolatların tür dağılımı ve antibiyotik duyarlılıkları. J Turk Soc Intens Care. 2017; 15: 21–27.
• 10. Breijyeh Z, Jubeh B, Karaman R. Resistance of Gram-negative bacteria to current antibacterial agents and approaches to resolve it. Molecules. 2020; 25(6): 1340.
• 11. Pasero D, Cossu AP, Terragni P. Multi-drug resistance bacterial infections in critically Ill patients admitted with COVID-19. Microorganisms. 2021; 9(8): 1773.
• 12. Almasaudi SB. Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features. Saudi J Biol Sci. 2018; (3): 586-596.
• 13. Dekic S, Hrenovic J, Ivankovic T, van Wilpe E. Survival of ESKAPE pathogen Acinetobacter baumannii in water of different temperatures and pH. Water Sci Technol. 2018; (5-6): 1370-1376.
• 14. Nowak P, Paluchowska P. Acinetobacter baumannii: biology and drug resistance - role of carbapenemases. Folia Histochem Cytobiol. 2016; 54(2): 61-74.
• 15. Rebic V, Masic N, Teskeredzic S, Aljicevic M, Abduzaimovic A, Rebic D. The importance of Acinetobacter species in the hospital environment. Med Arch. 2018; 72(5): 325-329.
• 16. Ceparano M, Baccolini V, Migliara G, Isonne C, Renzi E, Tufi D, et al. Acinetobacter baumannii isolates from COVID-19 patients in a hospital intensive care unit: Molecular typing and risk factors. Microorganisms. 2022; 10: 722.
• 17. Sharifipour E, Shams S, Esmkhani M, Khodadadi J, Fotouhi-Ardakani R, Koohpaei A, et al. Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU. BMC Infect Dis. 2020; 20(1): 646.
• 18. Syed RF, Yelamanchili S, Thati S. A comparative study of Acinetobacter infections in COVID and non-COVID patients. J Infect Dis Epidemiol. 2022; 8: 250.
• 19. Yu Y, Xu D, Fu S, Zhang J, Yang X, Xu L, et al. Patients with COVID-19 in 19 ICUs in Wuhan, China: A cross-sectional study. Crit Care. 2020; 24(1): 219.
• 20. Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii antibiotic resistance mechanisms. Pathogens. 2021; 10(3): 373.
• 21. CDC, Centre for Disease Control. Antibiotic resistance threats in the United States, 2019. U.S. Department of Health and Human Services, Atlanta, GA. Available from: https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf