Evaluation of Acinetobacter Baumannii, Klebsiella Pneumoniae, and Staphylococcus Aureus Respiratory Tract Superinfections Among Patients With Covid-19 at a Tertiary-Care Hospital in Tehran, Iran Publisher Pubmed



Mobarakqamsari M¹ ; Jenaghi B¹ ; Sahebi L² ; Norouzishadehi M³ ; Salehi MR⁴ ; Shakoorifarahani A⁵ ; Khoshnevis H⁶ ; Abdollahi A⁷ ; Feizabadi MM^{1, 8}
Source: European Journal of Medical Research Published:2023

Abstract

Background: The emergence of healthcare-associated infections (HAIs) or superinfections in COVID-19 patients has resulted in poor prognosis and increased mortality. Methods: In a cross-sectional study, 101 respiratory samples were collected from ICU-admitted COVID-19 patients. The HAI rate, demographics, and antibiotic resistance were assessed. Results: The HAI rate was 83.16% (76.62% bacterial and 6.54% fungal). The prevalence of 3 major HAI-causing organisms included Klebsiella pneumoniae (41.5%), Acinetobacter baumannii (20.8%), and Staphylococcus aureus (4.9%). Mortality and intubation ventilation proportions of 90% (p = 0.027) and 92.2% (p = 0.02) were significant among patients with superinfection, respectively. Multiple logistic regression analysis showed SpO2 pressure (odds ratio 0.842; 95% CI 0.750–0.945; p = 0.004) as a predictive factor in the association between antibiotic usage and mortality. More than 50% of patients received carbapenems. The resistance rates to at least one antibiotic of third-generation cephalosporins, aminoglycosides, quinolones/fluoroquinolones, tetracyclines, and β-lactam inhibitors were 95.2%, 95.2%, 90%, 57.1%, and 100% among A. baumannii isolates and 71.4%, 55%, 69%, 61.9%, and 59.5% among K. pneumoniae isolates, respectively. A proportion of 60% was recorded for methicillin-resistant S. aureus isolates. Conclusion: As a result, antibiotic treatment should be administered following the microbial resistance profile. Contact isolation and infection control measures should be implemented as needed. © 2023, BioMed Central Ltd., part of Springer Nature.