“Secondary Microbial Infections in Covid-19 Patients”

Abstract

Secondary infections are known complication of viral respiratory infections, often leads to deterioration of the patient. Secondary infections are commonly seen in severe respiratory viral infections.Critically ill novel coronavirus diseased 19 (COVID-19) patients need hospitalization which increases their risk of acquiring secondaryinfections. The practice of empiric antibiotics due to limited diagnostic capabilities of many hospitals has the potential to escalate an already worrisome antimicrobial resistance (AMR) situation. This study is undertaken to find out most effective antibiotic for empirical treatment. We aimed to define the impact of secondary microbial infections on the clinical course inCOVID-19 patients.

A retrospective study was carried out for a period of one year at RMCH& RC, Kanpur, and U.P. India. The patients admitted in intensive care units (ICUs) and wards of the hospitals were undertaken.

In our study a total of 262SARS CoV-2 positive patient’s pulmonary culture were assessed. Out of 262 cases,53 (20.2%) were culture positive.Prevalence of bacterial culture positive was 46(86.8%) and fungal positive culture was 7 (13.2%). The most common bacterial isolate was Klebsiella pneumoniae 18 (39.1%)followed by Acinetobacter baumannii 12(26.1%), Pseudomonas aeruginosa (17.4%), Escherichia coli 6(13.0%), andStaphylococcusaureus2(4.4%).The overall mortality was high among culture positive patients.The antimicrobial susceptibility pattern in K. pneumoniaeshowed highest resistanceagainst commonly used cephalosporins.

Predominance of Gram-negative bacteria (GNB) in COVID-19 patients coupled with high rates of resistance to higher generation antimicrobials is an alarming finding. A high rate of mortality in patients with secondary infections warns to improve the infection control practices andantimicrobial stewardship interventions, not only to save patient lives but also prevent drug-resistant, to which the current situation is very conducive.