Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia : A multicenter study

Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved..

OBJECTIVES: Superimposed multi-drug resistant organisms (MDROs) co-infection can be associated with worse outcomes in patients with severe coronavirus disease 2019 (COVID-19), even if these patients were managed with strict airborne and contact precautions. Identifying risk factors for isolation of MDROs is critical to COVID-19 treatment.

METHODS: All eligible adult patients with confirmed COVID-19 pneumonia from 10 hospitals in the Republic of Korea between February 2020 and May 2020 were retrospectively enrolled. Using this cohort, epidemiology and risk factors for isolation of MDROs were evaluated.

RESULTS: Of 152 patients, 47 with microbial culture results were included. Twenty isolates of MDROs from 13 (28%) patients were cultured. Stenotrophomonas maltophilia (5 isolates) was the most common MDRO, followed by methicillin-resistant staphylococcus aureus (4 isolates). MDROs were mostly isolated from sputum samples (80%, 16/20). The median time from hospitalization to MDRO isolation was 28 days (interquartile range, 18-38 days). In-hospital mortality was higher in patients with MDRO isolation (62% vs 15%; P = .001). Use of systemic corticosteroids after diagnosis of COVID-19 (adjusted odds ratio [aOR]: 15.07; 95% confidence interval [CI]: 2.34-97.01; P = .004) and long-term care facility (LTCF) stay before diagnosis of COVID-19 (aOR: 6.09; 95% CI: 1.02-36.49; P = .048) were associated with MDRO isolation.

CONCLUSIONS: MDROs were isolated from 28% of COVID-19 pneumonia patients with culture data and 8.6% of the entire cohort. Previous LTCF stay and adjunctive corticosteroid use were risk factors for the isolation of MDROs. Strict infection prevention strategies may be needed in these COVID-19 patients with risk factors.

Media Type:

Electronic Article

Year of Publication:


Contained In:

American journal of infection control - Vol. 49, No. 10 (2021), p. 1256-1261




Son, Hyo-Ju
Kim, Tark
Lee, Eunjung
Park, Se Yoon
Yu, Shinae
Hong, Hyo-Lim
Kim, Min-Chul
Hong, Sun In
Bae, Seongman
Kim, Min Jae
Kim, Sung-Han
Yun, Ji Hyun
Jo, Kyeong Min
Lee, Yu-Mi
Lee, Seungjae
Park, Jung Wan
Jeon, Min Hyok
Kim, Tae Hyong
Choo, Eun Ju




*Methicillin-Resistant Staphylococcus aureus
*Pharmaceutical Preparations
Antimicrobial resistance
Drug Resistance, Multiple, Bacterial
Journal Article
Long-term care facility
Multicenter Study
Pharmaceutical Preparations
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk Factors


Date Completed 29.09.2021

Date Revised 29.09.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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