Evaluation of Bi-Lateral Co-Infections and Antibiotic Resistance Rates among COVID-19 Patients.

Naveed Ahmed,Salman A Alsadiq,Waqas Saleem,Ali A Rabaan,Roshan Noor Mohamed,Mohmed Isaqali Karobari,Artak Heboyan,Saad Alhumaid,Ahmed S Bueid,Jeehan H Alestad,Madiha Khan,Eman Y Santali,Abbas Al Mutair

doi:10.3390/antibiotics11020276

Abstract

In addition to the pathogenesis of SARS-CoV-2, bacterial co-infection plays an essential role in the incidence and progression of SARS-CoV-2 infections by increasing the severity of infection, as well as increasing disease symptoms, death rate and antimicrobial resistance (AMR). The current study was conducted in a tertiary-care hospital in Lahore, Pakistan, among hospitalized COVID-19 patients to see the prevalence of bacterial co-infections and the AMR rates among different isolated bacteria. Clinical samples for the laboratory diagnosis were collected from 1165 hospitalized COVID-19 patients, of which 423 were found to be positive for various bacterial infections. Most of the isolated bacteria were Gram-negative rods (n = 366), followed by Gram-positive cocci (n = 57). A significant association (p < 0.05) was noted between the hospitalized COVID-19 patients and bacterial co-infections. Staphylococcus aureus (S. aureus) showed high resistance against tetracycline (61.7%), Streptococcus pyogenes against penicillin (100%), E. coli against Amp-clavulanic acid (88.72%), Klebsiella pneumoniae against ampicillin (100%), and Pseudomonas aeruginosa against ciprofloxacin (75.40%). Acinetobacter baumannii was 100% resistant to the majority of tested antibiotics. The prevalence of methicillin-resistant S. aureus (MRSA) was 14.7%. The topmost symptoms of >50% of COVID-19 patients were fever, fatigue, dyspnea and chest pain with a significant association (p < 0.05) in bacterial co-infected patients. The current study results showed a comparatively high prevalence of AMR, which may become a severe health-related issue in the future. Therefore, strict compliance of antibiotic usage and employment of antibiotic stewardship programs at every public or private institutional level are recommended.

Highlights

IntroductionCoronavirus or SARS-CoV-2 (severe acute respiratory syndrome) belongs to the coronaviridae family and is an enveloped single-stranded positive-sense RNA virus
Coronavirus or SARS-CoV-2 belongs to the coronaviridae family and is an enveloped single-stranded positive-sense RNA virus
All of the patients suffering from COVID-19 infection were admitted to different COVID-19 setting wards, and surgical intensive care units (SICUs) of the hospital were included in the study

Summary

Introduction

Coronavirus or SARS-CoV-2 (severe acute respiratory syndrome) belongs to the coronaviridae family and is an enveloped single-stranded positive-sense RNA virus. SARS-CoV-2 is a beta strain of the coronavirus family that causes severe acute respiratory syndrome. The virus responsible for coronavirus disease was first reported in December 2019 in Wuhan, China. In March 2020, the World Health Organization (WHO) declared it a pandemic [1]. In Wuhan, it was first observed as an outbreak of atypical pneumonia. Due to this disease, many hospitalized patients’ illnesses became more serious, and COVID-19 cases doubled within a week. It was concluded that the coronavirus family’s beta strain was responsible for this infection, which was later identified as SARS-CoV-2 [2]

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Conclusion