CLAINICO-BACTERIOLOGICAL SPECTRUMAND ANTIMICROBIAL RESISTANCE PROFILEIN BACTEREMIA COINFECTING COVID-19 PATIENTS IN A TERTIARY CARE HOSPITAL IN TRIPURA

Abstract

Background- Secondary bacterial infections including bacteremia have been implicated as a major cause of morbidity and mortality in COVID-19 patients So, it is important to determine the bacteriological profile of organisms responsible for bacteremia among COVID-19 patients along with their antimicrobial resistance pattern Objectives- To determine the bacteriological profile, antimicrobial resistance pattern and clinical outcome among COVID-19 patients with bacteremia as manifestation of secondary bacterial infection. Study design- Single center, cross sectional study Methods- Blood cultures were obtained from COVID-19 patients with features of bacteremia and sepsis based on Sepsis-3 criteria and serum procalcitonin level. Identification and AST were performed and the patients were followed until final outcome or discharge from hospital. Results- Among 43 blood samples obtained. 8 were positive in culture for pathogenic bacteria (18.6%). Mean age of the patients were 53.4 ± 14.9 years with male preponderance (62.5%). Mean procalcitonin level was 6.5±5.7 ng/ml. Positive history of contact was the major risk factor (62.5%) and mean duration of hospital stay was 11.1± 3.9 days. Mortality rate was 37.5%. Gram negative bacilli were the major isolates (75%) and one case was caused by an unusual organism Erysipelothrixrhusiopathiae. Among the Gram negative bacilli, maximum resistance was against Amikacin (100%) and minimum against Meropenem (16.7%). Out of GNB isolates, one isolate of Pseudomonas aeruginosa was Metallo ? lactamase enzyme producer and another one was multidrug resistant strain. Conclusion- Bacteremia among COVID-19 patients is a serious form of bacterial co-infection, leading to increased morbidity and mortality among the patients. High degree of clinical suspicion and increasing prolactin level must be complemented with blood culture to rule out bacteremia in these patients, where timely intervention and proper antimicrobial therapy can be lifesaving. Keywords- COVID-19, SARS-CoV-2, Coronavirus, Bacterial coinfection, Bacteremia, Antimicrobial resistance.