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Abstract：
The COVID-19 pandemic has raised concerns over secondary infections because it has limited treatment options and empiric antimicrobial treatment poses serious risks of aggravating antimicrobial resistance (AMR). Studies have shown that COVID-19 patients are predisposed to develop secondary infections. This study was conducted to ascertain the prevalence and profiles of co- & secondary infections in patients at the COVID-19 facility in North India.
We studied the profile of pathogens isolated from 290 clinical samples. Bacterial and fungal pathogens were identified, and antimicrobial susceptibility was determined by the Vitek2® system. Additionally, respiratory samples were tested for any viral/atypical bacterial co-infections and the presence of AMR genes by FilmArray test. The clinical and outcome data of these patients were also recorded for demographic and outcome measures analyses.
A total of 151 (13%) patients had secondary infections, and most got infected within the first 14 days of hospital admission. Patients aged >50 years developed severe symptoms (p = 0.0004) and/or had a fatal outcome (p = 0.0005). In-hospital mortality was 33%.K.pneumoniae (33.3%) was the predominant pathogen, followed by A. baumannii (27.1%). The overall resistance was up to 84%.Majority of the organisms were multidrug-resistant (MDR) harbouring MDR genes.
A high rate of secondary infections with resistant pathogens in COVID-19 patients highlights the importance of antimicrobial stewardship programs focussing on supporting the optimal selection of empiric treatment and rapid-de-escalation, based on culture reports.
We studied the profile of pathogens isolated from 290 clinical samples. Bacterial and fungal pathogens were identified, and antimicrobial susceptibility was determined by the Vitek2® system. Additionally, respiratory samples were tested for any viral/atypical bacterial co-infections and the presence of AMR genes by FilmArray test. The clinical and outcome data of these patients were also recorded for demographic and outcome measures analyses.
A total of 151 (13%) patients had secondary infections, and most got infected within the first 14 days of hospital admission. Patients aged >50 years developed severe symptoms (p = 0.0004) and/or had a fatal outcome (p = 0.0005). In-hospital mortality was 33%.K.pneumoniae (33.3%) was the predominant pathogen, followed by A. baumannii (27.1%). The overall resistance was up to 84%.Majority of the organisms were multidrug-resistant (MDR) harbouring MDR genes.
A high rate of secondary infections with resistant pathogens in COVID-19 patients highlights the importance of antimicrobial stewardship programs focussing on supporting the optimal selection of empiric treatment and rapid-de-escalation, based on culture reports.
摘要：
COVID-19大流行引起了人们对继发感染的担忧，因为它的治疗选择有限，经验性抗菌治疗会带来严重的抗生素耐药性（AMR）恶化的风险。研究表明，COVID-19患者容易发生继发感染。进行这项研究是为了确定印度北部COVID-19设施患者的合并和继发感染的患病率和概况。
我们研究了从290个临床样本中分离的病原体的概况。确定了细菌和真菌病原体，和抗菌药物敏感性由Vitek2®系统确定。此外,通过FilmArray测试,对呼吸道样本进行病毒/非典型细菌共感染和AMR基因的检测.这些患者的临床和结果数据也被记录用于人口统计学和结果测量分析。
共有151名（13%）患者出现二次感染，大多数人在入院后的前14天内被感染。年龄>50岁的患者出现严重症状（p=0.0004）和/或具有致命结果（p=0.0005）。住院死亡率为33%。K.肺炎(33.3%)是主要病原体，其次是鲍曼不动杆菌（27.1%）。总体阻力高达84%。大多数生物是携带MDR基因的多药耐药（MDR）。
COVID-19患者中耐药病原体的继发感染率很高，这凸显了抗菌药物管理计划的重要性，该计划专注于支持经验性治疗的最佳选择和快速降级。基于文化报告。
我们研究了从290个临床样本中分离的病原体的概况。确定了细菌和真菌病原体，和抗菌药物敏感性由Vitek2®系统确定。此外,通过FilmArray测试,对呼吸道样本进行病毒/非典型细菌共感染和AMR基因的检测.这些患者的临床和结果数据也被记录用于人口统计学和结果测量分析。
共有151名（13%）患者出现二次感染，大多数人在入院后的前14天内被感染。年龄>50岁的患者出现严重症状（p=0.0004）和/或具有致命结果（p=0.0005）。住院死亡率为33%。K.肺炎(33.3%)是主要病原体，其次是鲍曼不动杆菌（27.1%）。总体阻力高达84%。大多数生物是携带MDR基因的多药耐药（MDR）。
COVID-19患者中耐药病原体的继发感染率很高，这凸显了抗菌药物管理计划的重要性，该计划专注于支持经验性治疗的最佳选择和快速降级。基于文化报告。
