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Rothe, Kathrin; Feihl, Susanne; Schneider, Jochen; Wallnöfer, Fabian; Wurst, Milena; Lukas, Marina; Treiber, Matthias; Lahmer, Tobias; Heim, Markus; Dommasch, Michael; Waschulzik, Birgit; Zink, Alexander; Querbach, Christiane; Busch, Dirk H.; Schmid, Roland M.; Schneider, Gerhard; Spinner, Christoph D.

Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship

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  • Medientyp: E-Artikel
  • Titel: Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship
  • Beteiligte: Rothe, Kathrin; Feihl, Susanne; Schneider, Jochen; Wallnöfer, Fabian; Wurst, Milena; Lukas, Marina; Treiber, Matthias; Lahmer, Tobias; Heim, Markus; Dommasch, Michael; Waschulzik, Birgit; Zink, Alexander; Querbach, Christiane; Busch, Dirk H.; Schmid, Roland M.; Schneider, Gerhard; Spinner, Christoph D.
  • Erschienen: Springer Science and Business Media LLC, 2021
  • Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases, 40 (2021) 4, Seite 859-869
  • Sprache: Englisch
  • DOI: 10.1007/s10096-020-04063-8
  • ISSN: 0934-9723; 1435-4373
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:p>The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Bacterial co-infections are associated with unfavourable outcomes in respiratory viral infections; however, microbiological and antibiotic data related to COVID-19 are sparse. Adequate use of antibiotics in line with antibiotic stewardship (ABS) principles is warranted during the pandemic. We performed a retrospective study of clinical and microbiological characteristics of 140 COVID-19 patients admitted between February and April 2020 to a German University hospital, with a focus on bacterial co-infections and antimicrobial therapy. The final date of follow-up was 6 May 2020. Clinical data of 140 COVID-19 patients were recorded: The median age was 63.5 (range 17–99) years; 64% were males. According to the implemented local ABS guidelines, the most commonly used antibiotic regimen was ampicillin/sulbactam (41.5%) with a median duration of 6 (range 1–13) days. Urinary antigen tests for <jats:italic>Legionella pneumophila</jats:italic> and <jats:italic>Streptococcus peumoniae</jats:italic> were negative in all cases. In critically ill patients admitted to intensive care units (<jats:italic>n</jats:italic> = 50), co-infections with <jats:italic>Enterobacterales</jats:italic> (34.0%) and <jats:italic>Aspergillus fumigatus</jats:italic> (18.0%) were detected. Blood cultures collected at admission showed a diagnostic yield of 4.2%. Bacterial and fungal co-infections are rare in COVID-19 patients and are mainly prevalent in critically ill patients. Further studies are needed to assess the impact of antimicrobial therapy on therapeutic outcome in COVID-19 patients to prevent antimicrobial overuse. ABS guidelines could help in optimising the management of COVID-19. Investigation of microbial patterns of infectious complications in critically ill COVID-19 patients is also required.</jats:p>