Bacterial Coinfections in Coronavirus Disease 2019. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Westblade, Lars F.; Simon, Matthew S.; Satlin, Michael J.
• Is Part Of: Trends in microbiology. Volume 29:Issue 10(2021)
• Page Start: 930
• Page End: 941
• Publication Date: 2021-10
• Subjects: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -- coronavirus disease 2019 (COVID-19) -- bacterial coinfection -- hospital-acquired infections -- multidrug resistance (MDR); Microbiology -- Periodicals; Infection -- Periodicals; Virulence (Microbiology) -- Periodicals; Infection -- Periodicals; Microbiology -- Periodicals; Virulence -- Periodicals; Microbiologie -- Périodiques; Infection -- Périodiques; Virulence (Microbiologie) -- Périodiques; Infection; Microbiology; Virulence (Microbiology); 579
• DOI: 10.1016/j.tim.2021.03.018
• Languages: English
• ISSNs: 0966-842X

Abstract

Abstract : Bacterial coinfections increase the severity of respiratory viral infections and were frequent causes of mortality in influenza pandemics but have not been well characterized in patients with coronavirus disease 2019 (COVID-19). The aim of this review was to identify the frequency and microbial etiologies of bacterial coinfections that are present upon admission to the hospital and that occur during hospitalization for COVID-19. We found that bacterial coinfections were present in <4% of patients upon admission and the yield of routine diagnostic tests for pneumonia was low. When bacterial coinfections did occur, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae were the most common pathogens and atypical bacteria were rare. Although uncommon upon admission, bacterial infections frequently occurred in patients with prolonged hospitalization, and Pseudomonas aeruginosa, Klebsiella spp., and S. aureus were common pathogens. Antibacterial therapy and diagnostic testing for bacterial infections are unnecessary upon admission in most patients hospitalized with COVID-19, but clinicians should be vigilant for nosocomial bacterial infections. Highlights: Bacterial coinfections occur in <4% of patients who are hospitalized with COVID-19 and are usually caused by S. aureus, S. pneumoniae, and H. influenzae . Empirical antibacterial therapy and diagnostic testing for bacterial pathogens in patients hospitalized with COVID-19 are indicated only in those patients with critical illness, severe immunosuppression, radiographic findings suggestive of a bacterial pneumonia, or multiple laboratory parameters compatible with bacterial infection. Hospital-acquired infections are common among patients with prolonged hospitalization for COVID-19, and hospital-acquired pneumonia is most commonly caused by P. aeruginosa, Klebsiella spp., and S. aureus . Carbapenem-resistant Gram-negative infections are being increasingly reported in patients with COVID-19 requiring intensive care.