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.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

Journal of infection and public health - Vol. 14, No. 10 (2021), p. 1375-1380

Language:

English

Contributors:

Meawed, Takwa E
Ahmed, Sherweet M
Mowafy, Sherif M S
Samir, Ghada M
Anis, Reham H

Links:

Volltext

Keywords:

*COVID-19
*Pneumonia, Ventilator-Associated
Antimicrobial resistance
Bacteria
Bacterial
COVID-19
Critical Illness
Fungal
Fungi
Humans
Intensive Care Units
Journal Article
SARS-CoV-2
SARS-CoV2
Ventilator associated pneumonia

Notes:

Date Completed 12.10.2021

Date Revised 12.10.2021

published: Print-Electronic

Citation Status MEDLINE

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

Physical Description:

Online-Ressource

doi:

10.1016/j.jiph.2021.08.003

PMID:

34420902

PPN (Catalogue-ID):

NLM330826301