Diagnostic significance of secondary bacteremia in patients with COVID-19. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Nakagawara, Kensuke; Kamata, Hirofumi; Chubachi, Shotaro; Namkoong, Ho; Tanaka, Hiromu; Lee, Ho; Otake, Shiro; Fukushima, Takahiro; Kusumoto, Tatsuya; Morita, Atsuho; Azekawa, Shuhei; Watase, Mayuko; Asakura, Takanori; Masaki, Katsunori; Ishii, Makoto; Endo, Akifumi; Koike, Ryuji; Ishikura, Hiroyasu; Takata, Tohru; Matsushita, Yasushi; Harada, Norihiro; Kokutou, Hiroyuki; Yoshiyama, Takashi; Kataoka, Kensuke; Mutoh, Yoshikazu; Miyawaki, Masayoshi; Ueda, Soichiro; Ono, Hiroshi; Ono, Takuya; Shoko, Tomohisa; Muranaka, Hiroyuki; Kawamura, Kodai; Mori, Nobuaki; Mochimaru, Takao; Fukui, Mototaka; Chihara, Yusuke; Nagasaki, Yoji; Okamoto, Masaki; Amishima, Masaru; Odani, Toshio; Tani, Mayuko; Nishi, Koichi; Shirai, Yuya; Edahiro, Ryuya; Ando, Akira; Hashimoto, Naozumi; Ogura, Shinji; Kitagawa, Yuichiro; Kita, Toshiyuki; Kagaya, Takashi; Kimura, Yasuhiro; Miyazawa, Naoki; Tsuchida, Tomoya; Fujitani, Shigeki; Murakami, Koji; Sano, Hirohito; Sato, Yuki; Tanino, Yoshinori; Otsuki, Ryo; Mashimo, Shuko; Kuramochi, Mizuki; Hosoda, Yasuo; Hasegawa, Yoshinori; Ueda, Tetsuya; Takaku, Yotaro; Ishiguro, Takashi; Fujiwara, Akiko; Kuwahara, Naota; Kitamura, Hideya; Hagiwara, Eri; Nakamori, Yasushi; Saito, Fukuki; Kono, Yuta; Abe, Shinji; Ishii, Tomoo; Ohba, Takehiko; Kusaka, Yu; Watanabe, Hiroko; Masuda, Makoto; Watanabe, Hiroki; Kimizuka, Yoshifumi; Kawana, Akihiko; Kasamatsu, Yu; Hashimoto, Satoru; Okada, Yukinori; Takano, Tomomi; Katayama, Kazuhiko; Ai, Masumi; Kumanogoh, Atsushi; Sato, Toshiro; Tokunaga, Katsushi; Imoto, Seiya; Kitagawa, Yuko; Kimura, Akinori; Miyano, Satoru; Hasegawa, Naoki; Ogawa, Seishi; Kanai, Takanori; Fukunaga, Koichi;
• Is Part Of: Journal of infection and chemotherapy. Volume 29:Issue 4(2023)
• Page Start: 422
• Page End: 426
• Publication Date: 2023-04
• Subjects: SARS-CoV-2 infection -- Bacteremia -- Secondary infection -- Fungemia -- Mortality; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2023.01.006
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Objectives: We investigated the occurrence of non-respiratory bacterial and fungal secondary infections, causative organisms, impact on clinical outcomes, and association between the secondary pathogens and mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). Methods: This was a retrospective cohort study that included data from inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021). We obtained demographic, epidemiological, and microbiological data throughout the course of hospitalization and analyzed the cases of COVID-19 complicated by non-respiratory bacterial infections. Results: Of the 1914 patients included, non-respiratory bacterial infections with COVID-19 were diagnosed in 81 patients (4.2%). Of these, 59 (3.1%) were secondary infections. Bacteremia was the most frequent bacterial infection, occurring in 33 cases (55.9%), followed by urinary tract infections in 16 cases (27.1%). Staphylococcus epidermidis was the most common causative organism of bacteremia. Patients with COVID-19 with non-respiratory secondary bacterial infections had significantly higher mortality, and a multivariate logistic regression analysis demonstrated that those with bacteremia (aOdds Ratio = 15.3 [5.97–39.1]) were at higher risk of death. Multivariate logistic regression analysis showed that age, male sex, use of steroids to treat COVID-19, and intensive care unit admission increased the risk for nosocomial bacteremia. Conclusions: Secondary bacteremia is an important complication that may lead to poor prognosis in cases with COVID-19. An appropriate medical management strategy must be established, especially for patients with concomitant predisposing factors.