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Lavrinenko A, Kolesnichenko S, Kadyrova I, Turmukhambetova A, Akhmaltdinova L, Klyuyev D. Bacterial Co-Infections and Antimicrobial Resistance in Patients Hospitalized with Suspected or Confirmed COVID-19 Pneumonia in Kazakhstan. Pathogens 2023; 12:pathogens12030370. [PMID: 36986292 PMCID: PMC10052929 DOI: 10.3390/pathogens12030370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023] Open
Abstract
Our study was carried out to characterize respiratory tract microbiota in patients with “COVID-like pneumonia” in Kazakhstan and analyze differences between COVID-19 positive and negative groups. Sputum samples were collected from hospitalized patients, ≥18 years old, in the three cities in Kazakhstan with the highest COVID-19 burden in July 2020. Isolates were identified by MALDI-TOF MS. Susceptibility testing was performed by disk diffusion. We used SPSS 26 and MedCalc 19 for statistical analysis. Among 209 patients with pneumonia, the median age was 62 years and 55% were male. RT-PCR-confirmed SARS-CoV-2 cases were found in 40% of patients, and 46% had a bacterial co-infection. Co-infection was not associated with SARS-CoV-2 RT-PCR test results, but antibiotic use was. The most frequent bacteria were Klebsiella pneumoniae (23%), Escherichia coli (12%), and Acinetobacter baumannii (11%). Notably, 68% of Klebsiella pneumoniae had phenotypic evidence of extended-spectrum beta-lactamases in disk diffusion assays, 87% of Acinetobacter baumannii exhibited resistance to beta-lactams, and >50% of E. coli strains had evidence of ESBL production and 64% were resistant to fluoroquinolones. Patients with a bacterial co-infection had a higher proportion of severe disease than those without a co-infection. The results reinforce the importance of using appropriate targeted antibiotics and effective infection control practices to prevent the spread of resistant nosocomial infections.
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Affiliation(s)
- Alyona Lavrinenko
- Research Laboratory, Karaganda Medical University, Karaganda 100008, Kazakhstan
| | - Svetlana Kolesnichenko
- Research Laboratory, Karaganda Medical University, Karaganda 100008, Kazakhstan
- Correspondence: ; Tel.: +7-702-599-0225
| | - Irina Kadyrova
- Research Laboratory, Karaganda Medical University, Karaganda 100008, Kazakhstan
| | - Anar Turmukhambetova
- Management Department, Karaganda Medical University, Karaganda 100008, Kazakhstan
| | | | - Dmitriy Klyuyev
- Research Laboratory, Karaganda Medical University, Karaganda 100008, Kazakhstan
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Pinte L, Ceasovschih A, Niculae CM, Stoichitoiu LE, Ionescu RA, Balea MI, Cernat RC, Vlad N, Padureanu V, Purcarea A, Badea C, Hristea A, Sorodoc L, Baicus C. Antibiotic Prescription and in-Hospital Mortality in COVID-19: A Prospective Multicentre Cohort Study. J Pers Med 2022; 12:jpm12060877. [PMID: 35743662 PMCID: PMC9224767 DOI: 10.3390/jpm12060877] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Since the beginning of the COVID-19 pandemic, empiric antibiotics (ATBs) have been prescribed on a large scale in both in- and outpatients. We aimed to assess the impact of antibiotic treatment on the outcomes of hospitalised patients with moderate and severe coronavirus disease 2019 (COVID-19). Methods: We conducted a prospective multicentre cohort study in six clinical hospitals, between January 2021 and May 2021. Results: We included 553 hospitalised COVID-19 patients, of whom 58% (311/553) were prescribed antibiotics, while bacteriological tests were performed in 57% (178/311) of them. Death was the outcome in 48 patients—39 from the ATBs group and 9 from the non-ATBs group. The patients who received antibiotics during hospitalisation had a higher mortality (RR = 3.37, CI 95%: 1.7–6.8), and this association was stronger in the subgroup of patients without reasons for antimicrobial treatment (RR = 6.1, CI 95%: 1.9–19.1), while in the subgroup with reasons for antimicrobial therapy the association was not statistically significant (OR = 2.33, CI 95%: 0.76–7.17). After adjusting for the confounders, receiving antibiotics remained associated with a higher mortality only in the subgroup of patients without criteria for antibiotic prescription (OR = 10.3, CI 95%: 2–52). Conclusions: In our study, antibiotic treatment did not decrease the risk of death in the patients with mild and severe COVID-19, but was associated with a higher risk of death in the subgroup of patients without reasons for it.
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Affiliation(s)
- Larisa Pinte
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Department of Internal Medicine, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Clinical Research Unit, Reseau d’Epidemiologie Clinique International Francophone, 020125 Bucharest, Romania
- Correspondence:
| | - Alexandr Ceasovschih
- Department of Internal Medicine, Clinical Emergency Hospital Sfantul Spiridon, 700111 Iasi, Romania; (A.C.); (L.S.)
- Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristian-Mihail Niculae
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Department of Infectious Diseases, National Institute for Infectious Diseases Prof. Dr. Matei Bals, 021105 Bucharest, Romania
| | - Laura Elena Stoichitoiu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Department of Internal Medicine, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Clinical Research Unit, Reseau d’Epidemiologie Clinique International Francophone, 020125 Bucharest, Romania
| | - Razvan Adrian Ionescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Department of Internal Medicine, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Clinical Research Unit, Reseau d’Epidemiologie Clinique International Francophone, 020125 Bucharest, Romania
| | - Marius Ioan Balea
- Department of Pneumology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Roxana Carmen Cernat
- Faculty of Medicine, Ovidius University, 900527 Constanta, Romania; (R.C.C.); (N.V.)
- Department of Infectious Diseases, Clinical Hospital of Infectious Diseases, 900178 Constanta, Romania
| | - Nicoleta Vlad
- Faculty of Medicine, Ovidius University, 900527 Constanta, Romania; (R.C.C.); (N.V.)
- Department of Infectious Diseases, Clinical Hospital of Infectious Diseases, 900178 Constanta, Romania
| | - Vlad Padureanu
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania;
- Department of Internal Medicine, Craiova Emergency County Hospital, 200642 Craiova, Romania
| | - Adrian Purcarea
- Department of Internal Medicine, Sacele County Hospital, 505600 Brasov, Romania;
| | - Camelia Badea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Department of Internal Medicine, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Adriana Hristea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Clinical Research Unit, Reseau d’Epidemiologie Clinique International Francophone, 020125 Bucharest, Romania
- Department of Infectious Diseases, National Institute for Infectious Diseases Prof. Dr. Matei Bals, 021105 Bucharest, Romania
| | - Laurenţiu Sorodoc
- Department of Internal Medicine, Clinical Emergency Hospital Sfantul Spiridon, 700111 Iasi, Romania; (A.C.); (L.S.)
- Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristian Baicus
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-M.N.); (L.E.S.); (R.A.I.); (C.B.); (A.H.); (C.B.)
- Department of Internal Medicine, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Clinical Research Unit, Reseau d’Epidemiologie Clinique International Francophone, 020125 Bucharest, Romania
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