Profile of Secondary Bacterial and Fungal Infections in Hospitalized COVID-19 Patients in a Tertiary Care Centre.

Abstract

IntroductionSARS CoV-2, a novel corona virus, has emerged in December 2019. The COVID-19 associated mortality is documented in elderly with co morbidities. To have better insight on this issue, the secondary bacterial infections with multi-drug-resistant bacteria in COVID-19 patients need to be studied to evaluate the impact of these infections on the outcome.Aim and objectivesTo determine the proportion of secondary infections in COVID-19 patients. To study the spectrum of pathogens and antibiogram of the bacteria isolated from secondary infections in such patients. To evaluate the co-existing co-morbidities, treatment and outcome in these patients.MethodologyThe retrospective study was conducted in Departments of Medicine and Microbiology, KMC hospitals Attavara and Ambedkar circle, Mangaluru, including all the hospitalized microbiologically confirmed cases of SARS CoV-2 infection. Details pertaining to the study population were collected using a structured proforma. Descriptive data were entered in the form of mean, median and proportions. The categorical values were analyzed using Chi square test. Values of p < 0.05 were considered as statistically significant.ResultsTwo hundred COVID-19 hospitalized patients were included.28 out of 200 patients (14%) studied developed secondary infections. The types of secondary infections were Respiratory infections (50%), blood stream infections (17%), UTI (14%), Rhinocerebral Zygomycosis (17%). The predominant organisms were Klebsiella pneumoniae (44%), Zygomycetes (17%). The rates of antibiotic resistance in Gram negative bacilli were 33% to Cefuroxime,25% to aminoglycosides and fluoroquinolones and 16% to carbapenems. The mortality of 42.8% was observed in patients with secondary infections.ConclusionClose monitoring and follow up especially in high-risk group of severe COVID 19 patients is crucial for better management and outcome.