Investigation Of Bacterial Coinfection Among Hospitalized Patients With COVID-19: A Retrospective Study In A Turkey Training And Research Hospital

Abstract

Objective: In the present study, we aimed to determine the distribution and antibiotic resistance rates of bacteria isolated from endotracheal aspirates (ETA), blood, catheters, urinary, and sputum taken from COVID-19 patients who hospitalized in the Siirt Training and Research Hospital. Methods: A retrospective observational analysis of all COVID-19 patients hospitalized in Siirt Training and Research Hospital was undertaken. We determined the distribution and antibiotic resistance rates of bacteria isolated from endotracheal aspirates (ETA), blood, catheters, urinary, and sputum taken from COVID-19 patients who hospitalized in the Siirt Training and Research Hospital. between March 2020 and July 2020. Results: In this study, we identified a total of 720 patients with confirmed SARS-CoV-2 during the study period (15 March 2020 to 1 July 2020). Significant growth was detected in 64 (8.9%) of Endotracheal aspirate (ETA), blood, catheter and urinary samples admitted to our laboratory in 3.5 months period. Most bacteria detected in blood (41) and ETA (15) samples. In the 36 Gram-positive bacteria detected in the blood cultures, 19 Coagulase negative Staphylococcus (CNS), 7 Enterococcus spp., 5 Staphylococcus epidermidis, 2 Staphylococcus hominis, 2 Staphylococcus capitis and 1 staphylococcus haemolyticus were identified. In the 4 Gram-positive bacteria detected in the catheter samples, 2 CNS, 1 Staphylococcus aureus and 1 S. capitis were identified. No Gram-positive bacteria were grown in the ETA. In the 15 Gram-negative bacteria detected in ETA, 13 Acinetobacter baumannii and 2 Klebsiella spp. were identified. In the 5 Gram-negative bacteria detected in blood cultures, 3 A. baumannii, 1 E. coli 1 Klebsiella spp. were identified and In the 3 Gram-negative bacteria detected in catheter, 2 A. baumannii and 1 Pseudomonas aeruginosa were identified. Among Gram-positive bacteria, methicillin resistances were detected in 57.9 % (n=11) of CNS and vancomycin resistance rates were 14.3% in Enterococcus spp. isolated from blood samples. The A. baumannii isolates from ETA were found to be resistance at least three antibiotics. We detected that 100% (n=13) of A. baumannii isolated from ETA were resistant to piperacillin-tazobactam, meropenem, ciprofloxacin, ceftazidime and 61.5% of resistant to amikacin. 2 Klebsiella spp. isolated from ETA were resistant to ciprofloxacin, amicasin, piperacillin-tazobactam, meropenem, tigesicline, trimethoprim-sulfamethoxazol and ceftazidime and 1 P. aeruginosa isolated from catheter cultures was found to be resistant to amikasin, piperacillin-tazobactam, meropenem, ciprofloxacin, trimethoprim-sulfamethoxazol and ceftazidime. Conclusion: As a result, the frequency of microbiologically confirmed bacterial co-infections was found low in confirmed SARS-CoV-2 patients admitted to our hospital. Nevertheless, when present, they can cause serious illness with worse consequences. Since the incidence, nature, and effect of late secondary bacterial infections are less clear, more studies are needed.