Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study
© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
BACKGROUND: Bacterial infections may complicate viral pneumonias. Recent reports suggest that bacterial co-infection at time of presentation is uncommon in coronavirus disease 2019 (COVID-19); however, estimates were based on microbiology tests alone. We sought to develop and apply consensus definitions, incorporating clinical criteria to better understand the rate of co-infections and antibiotic use in COVID-19.
METHODS: A total of 1016 adult patients admitted to 5 hospitals in the Johns Hopkins Health System between March 1, 2020, and May 31, 2020, with COVID-19 were evaluated. Adjudication of co-infection using definitions developed by a multidisciplinary team for this study was performed. Both respiratory and common nonrespiratory co-infections were assessed. The definition of bacterial community-acquired pneumonia (bCAP) included proven (clinical, laboratory, and radiographic criteria plus microbiologic diagnosis), probable (clinical, laboratory, and radiographic criteria without microbiologic diagnosis), and possible (not all clinical, laboratory, and radiographic criteria met) categories. Clinical characteristics and antimicrobial use were assessed in the context of the consensus definitions.
RESULTS: Bacterial respiratory co-infections were infrequent (1.2%); 1 patient had proven bCAP, and 11 (1.1%) had probable bCAP. Two patients (0.2%) had viral respiratory co-infections. Although 69% of patients received antibiotics for pneumonia, the majority were stopped within 48 hours in patients with possible or no evidence of bCAP. The most common nonrespiratory infection was urinary tract infection (present in 3% of the cohort).
CONCLUSIONS: Using multidisciplinary consensus definitions, proven or probable bCAP was uncommon in adults hospitalized due to COVID-19, as were other nonrespiratory bacterial infections. Empiric antibiotic use was high, highlighting the need to enhance antibiotic stewardship in the treatment of viral pneumonias.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
|---|---|
| Enthalten in: |
Open forum infectious diseases - 8(2021), 1 vom: 28. Jan., Seite ofaa578 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Karaba, Sara M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Antimicrobial use |
|---|
| Anmerkungen: |
Date Revised 30.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1093/ofid/ofaa578 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM320108619 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM320108619 | ||
| 003 | DE-627 | ||
| 005 | 20240330235423.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ofid/ofaa578 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1357.xml |
| 035 | |a (DE-627)NLM320108619 | ||
| 035 | |a (NLM)33447639 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Karaba, Sara M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 30.03.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a BACKGROUND: Bacterial infections may complicate viral pneumonias. Recent reports suggest that bacterial co-infection at time of presentation is uncommon in coronavirus disease 2019 (COVID-19); however, estimates were based on microbiology tests alone. We sought to develop and apply consensus definitions, incorporating clinical criteria to better understand the rate of co-infections and antibiotic use in COVID-19 | ||
| 520 | |a METHODS: A total of 1016 adult patients admitted to 5 hospitals in the Johns Hopkins Health System between March 1, 2020, and May 31, 2020, with COVID-19 were evaluated. Adjudication of co-infection using definitions developed by a multidisciplinary team for this study was performed. Both respiratory and common nonrespiratory co-infections were assessed. The definition of bacterial community-acquired pneumonia (bCAP) included proven (clinical, laboratory, and radiographic criteria plus microbiologic diagnosis), probable (clinical, laboratory, and radiographic criteria without microbiologic diagnosis), and possible (not all clinical, laboratory, and radiographic criteria met) categories. Clinical characteristics and antimicrobial use were assessed in the context of the consensus definitions | ||
| 520 | |a RESULTS: Bacterial respiratory co-infections were infrequent (1.2%); 1 patient had proven bCAP, and 11 (1.1%) had probable bCAP. Two patients (0.2%) had viral respiratory co-infections. Although 69% of patients received antibiotics for pneumonia, the majority were stopped within 48 hours in patients with possible or no evidence of bCAP. The most common nonrespiratory infection was urinary tract infection (present in 3% of the cohort) | ||
| 520 | |a CONCLUSIONS: Using multidisciplinary consensus definitions, proven or probable bCAP was uncommon in adults hospitalized due to COVID-19, as were other nonrespiratory bacterial infections. Empiric antibiotic use was high, highlighting the need to enhance antibiotic stewardship in the treatment of viral pneumonias | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a antimicrobial use | |
| 650 | 4 | |a co-infection | |
| 650 | 4 | |a community-acquired pneumonia | |
| 700 | 1 | |a Jones, George |e verfasserin |4 aut | |
| 700 | 1 | |a Helsel, Taylor |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, L Leigh |e verfasserin |4 aut | |
| 700 | 1 | |a Avery, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Dzintars, Kathryn |e verfasserin |4 aut | |
| 700 | 1 | |a Salinas, Alejandra B |e verfasserin |4 aut | |
| 700 | 1 | |a Keller, Sara C |e verfasserin |4 aut | |
| 700 | 1 | |a Townsend, Jennifer L |e verfasserin |4 aut | |
| 700 | 1 | |a Klein, Eili |e verfasserin |4 aut | |
| 700 | 1 | |a Amoah, Joe |e verfasserin |4 aut | |
| 700 | 1 | |a Garibaldi, Brian T |e verfasserin |4 aut | |
| 700 | 1 | |a Cosgrove, Sara E |e verfasserin |4 aut | |
| 700 | 1 | |a Fabre, Valeria |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Open forum infectious diseases |d 2014 |g 8(2021), 1 vom: 28. Jan., Seite ofaa578 |w (DE-627)NLM243576811 |x 2328-8957 |7 nnns |
| 773 | 1 | 8 | |g volume:8 |g year:2021 |g number:1 |g day:28 |g month:01 |g pages:ofaa578 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ofid/ofaa578 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 8 |j 2021 |e 1 |b 28 |c 01 |h ofaa578 | ||