Multidrug-resistant organism infections correlate with increased mortality in COVID-19 patients: A retrospective, observational cohort study

Abstract

Background: The uncontrolled use of antibiotics is a big problem that will lead to antibiotic resistance. One of the recommendations for Corona Virus Disease 2019 (COVID-19) therapy is antibiotics. This study aimed to present the incidence of multidrug-resistant organism (MDRO) infections in COVID-19 patients and the risk of mortality in COVID-19 patients in the Indonesian population. Materials and Methods: A retrospective cohort study was conducted at a tertiary medical center in Indonesia. A total of 120 subjects were included in this study and divided equally into group M (COVID-19 patients with MDRO infections) and group N (without MDRO). The culture was conducted between the 17th and 10th days of treatment. A 2 × 2 table and chi-square test calculated the relative risk (RR) of MDRO causing mortality in COVID-19 patients. Results: The median age was 52 and 51 years old in groups M and N, respectively (P = 0.599). Based on the documented data related to microbiological culture to detect the types of microorganisms, carbapenem-resistant Acinetobacter baumannii was found to be the most MDRO isolated (30%), followed by extended-spectrum beta-lactamase (26.6%). Bivariate analysis showed that MDRO infection strongly correlates with the incidence of death with a RR of 4.167 (P < 0.001). Conclusion: MDRO infection is significantly correlated with mortality in COVID-19 patients. MDRO infections pose a four-fold chance of mortality compared to those without MDRO infections.