目的:本研究旨在分析细菌组成,分布,药物敏感性,发生细菌共感染的COVID-19患者的临床特征。
方法:我们对2022年12月至2023年1月期间收治的184例COVID-19患者进行了回顾性研究。性别数据,年龄,住院时间,肺炎分类,潜在的疾病,侵入性手术,激素治疗,炎症指标,收集了其他相关信息。痰样本,支气管镜检查痰,肺泡灌洗液,中间尿液,穿刺液,伤口分泌物,收集血液用于病原体分离,identification,和药物敏感性测试。
结果:COVID-19合并细菌感染的患者多数为老年患者,有基础疾病。有创手术和激素治疗被确定为共同感染的危险因素。实验室分析显示淋巴细胞计数减少,CRP和PCT水平升高。合并感染中最常见的病原体是金黄色葡萄球菌,大肠杆菌,肺炎克雷伯菌,A.鲍曼尼,还有铜绿假单胞菌.耐药菌株检出率,包括MRSA,CRKP,CRAB,CRPA,和CRECO,随着肺炎的严重程度而增加。
结论:呼吸道感染是COVID-19患者细菌共感染的最常见部位。重症病例更容易感染多重耐药病原体,导致更高的死亡率。及时控制和预防合并感染对改善COVID-19患者的预后至关重要。
OBJECTIVE: This study aimed to analyse the bacterial composition, distribution, drug sensitivity, and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who develop bacterial co-infections.
METHODS: We conducted a retrospective study of 184 patients with COVID-19 admitted between December 2022 and January 2023. Data on gender, age, length of hospital stay, pneumonia classification, underlying diseases, invasive surgery, hormone therapy, inflammation indicators, and other relevant information were collected. Samples of sputum, bronchoscopy sputum, alveolar lavage fluid, middle urine, puncture fluid, wound secretions, and blood were collected for pathogen isolation, identification, and drug sensitivity testing.
RESULTS: The majority of patients with COVID-19 with bacterial co-infection were elderly and had underlying diseases. Invasive surgery and hormone therapy were identified as risk factors for co-infections. Laboratory analysis showed reduced lymphocyte counts and elevated levels of C-reactive protein and procalcitonin. The most common pathogens in co-infections were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. The detection rate of drug-resistant strains, including methicillin-resistant S. aureus, carbapenem-resistant K. pneumoniae, carbapenem-resistant A. baumannii, carbapenem-resistant P. aeruginosa, and carbapenem-resistant E. coli, increased with the severity of pneumonia.
CONCLUSIONS: Respiratory tract infections were the most common site of bacterial co-infection in patients with COVID-19. Severe cases were more susceptible to multidrug-resistant pathogens, leading to a higher mortality rate. Timely control and prevention of co-infection are crucial for improving the prognosis of patients with COVID-19.