Bacterial and fungal ventilator associated pneumonia in critically ill COVID-19 patients during the second wave
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved..
BACKGROUND: The pandemic of coronavirus disease (COVID-19) has caused huge number of patients admitted to intensive care units (ICUs) in a critical need to mechanical ventilation. Ventilator associated pneumonia (VAP) has been noticed as a common complication in these patients with unfavorable outcomes. The current study aimed to assess bacterial and fungal VAP in COVID-19 patients admitted to ICUs during the second wave and to identify the possible risk factors.
METHODS: Respiratory samples were collected from 197 critically ill COVID-19 patients under mechanical ventilation. Bacterial and fungal superinfections were diagnosed by microbiological cultures with subsequent antimicrobial susceptibility testing of the isolates using available kits.
RESULTS: All specimens 197/197 (100%) were positive for bacterial infections, while fungal elements were detected in 134/197 (68%) of specimens. The most frequently isolated bacteria were pan drug resistant (PDR) Klebsiella pneumoniae (41.1%), followed by multi drug resistant (MDR) Acinetobacter baumannii (27.4%). On the other hand, Candida species represented the most frequently isolated fungi (75.4%) followed by molds including Aspergillus (16.4%) and Mucor (8.2%) species. Possible risk factors for fungal VAP included underlying diabetes mellitus (95% confidence interval [CI] 1.09-3.31; p = 0.02), chest disease (95% CI 1.01-3.32; p = 0.05), hypothyroidism (95% CI 1.01-4.78; p = 0.05), and longer duration of mechanical ventilation (p < 0.001). Furthermore, all patients 134/134 (100%) who developed fungal VAP, were already under treatment with corticosteroids and Tocilizumab.
CONCLUSION: Bacterial and fungal VAP in critically ill COVID-19 patients is a serious problem in the current pandemic. Urgent and strategic steps to keep it under control are compulsory.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Journal of infection and public health - 14(2021), 10 vom: 19. Okt., Seite 1375-1380 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Meawed, Takwa E [VerfasserIn] |
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| Links: |
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| Themen: |
Antimicrobial resistance |
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| Anmerkungen: |
Date Completed 12.10.2021 Date Revised 12.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jiph.2021.08.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM329642634 |
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| 500 | |a Date Revised 12.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a BACKGROUND: The pandemic of coronavirus disease (COVID-19) has caused huge number of patients admitted to intensive care units (ICUs) in a critical need to mechanical ventilation. Ventilator associated pneumonia (VAP) has been noticed as a common complication in these patients with unfavorable outcomes. The current study aimed to assess bacterial and fungal VAP in COVID-19 patients admitted to ICUs during the second wave and to identify the possible risk factors | ||
| 520 | |a METHODS: Respiratory samples were collected from 197 critically ill COVID-19 patients under mechanical ventilation. Bacterial and fungal superinfections were diagnosed by microbiological cultures with subsequent antimicrobial susceptibility testing of the isolates using available kits | ||
| 520 | |a RESULTS: All specimens 197/197 (100%) were positive for bacterial infections, while fungal elements were detected in 134/197 (68%) of specimens. The most frequently isolated bacteria were pan drug resistant (PDR) Klebsiella pneumoniae (41.1%), followed by multi drug resistant (MDR) Acinetobacter baumannii (27.4%). On the other hand, Candida species represented the most frequently isolated fungi (75.4%) followed by molds including Aspergillus (16.4%) and Mucor (8.2%) species. Possible risk factors for fungal VAP included underlying diabetes mellitus (95% confidence interval [CI] 1.09-3.31; p = 0.02), chest disease (95% CI 1.01-3.32; p = 0.05), hypothyroidism (95% CI 1.01-4.78; p = 0.05), and longer duration of mechanical ventilation (p < 0.001). Furthermore, all patients 134/134 (100%) who developed fungal VAP, were already under treatment with corticosteroids and Tocilizumab | ||
| 520 | |a CONCLUSION: Bacterial and fungal VAP in critically ill COVID-19 patients is a serious problem in the current pandemic. Urgent and strategic steps to keep it under control are compulsory | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antimicrobial resistance | |
| 650 | 4 | |a Bacterial | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Fungal | |
| 650 | 4 | |a SARS-CoV2 | |
| 650 | 4 | |a Ventilator associated pneumonia | |
| 700 | 1 | |a Ahmed, Sherweet M |e verfasserin |4 aut | |
| 700 | 1 | |a Mowafy, Sherif M S |e verfasserin |4 aut | |
| 700 | 1 | |a Samir, Ghada M |e verfasserin |4 aut | |
| 700 | 1 | |a Anis, Reham H |e verfasserin |4 aut | |
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