Bacterial pulmonary superinfections are associated with longer duration of ventilation in critically ill COVID-19 patients.
Aged
Bronchoalveolar Lavage Fluid
/ microbiology
COVID-19
/ complications
Cohort Studies
Critical Illness
Enterococcus faecalis
/ isolation & purification
Female
Humans
Incidence
Intensive Care Units
Length of Stay
Male
Middle Aged
Pseudomonas aeruginosa
/ isolation & purification
Respiration, Artificial
SARS-CoV-2
/ isolation & purification
Superinfection
/ complications
Time Factors
ARDS
COVID-19
SARS-CoV-2
acute respiratory distress syndrome
antibiotic therapy
bacterial superinfection
co-infection
coronavirus disease 19
invasive mechanical ventilation
longitudinal sampling
severe acute respiratory syndrome coronavirus 2
ventilator free at 28 days
Journal
Cell reports. Medicine
ISSN: 2666-3791
Titre abrégé: Cell Rep Med
Pays: United States
ID NLM: 101766894
Informations de publication
Date de publication:
20 04 2021
20 04 2021
Historique:
received:
26
11
2020
revised:
29
01
2021
accepted:
09
03
2021
pubmed:
23
3
2021
medline:
23
3
2021
entrez:
22
3
2021
Statut:
ppublish
Résumé
The impact of secondary bacterial infections (superinfections) in coronavirus disease 2019 (COVID-19) is not well understood. In this prospective, monocentric cohort study, we aim to investigate the impact of superinfections in COVID-19 patients with acute respiratory distress syndrome. Patients are assessed for concomitant microbial infections by longitudinal analysis of tracheobronchial secretions, bronchoalveolar lavages, and blood cultures. In 45 critically ill patients, we identify 19 patients with superinfections (42.2%). Superinfections are detected on day 10 after intensive care admission. The proportion of participants alive and off invasive mechanical ventilation at study day 28 (ventilator-free days [VFDs] at 28 days) is substantially lower in patients with superinfection (subhazard ratio 0.37; 95% confidence interval [CI] 0.15-0.90; p = 0.028). Patients with pulmonary superinfections have a higher incidence of bacteremia, virus reactivations, yeast colonization, and required intensive care treatment for a longer time. Superinfections are frequent and associated with reduced VFDs at 28 days despite a high rate of empirical antibiotic therapy.
Identifiants
pubmed: 33748789
doi: 10.1016/j.xcrm.2021.100229
pii: S2666-3791(21)00045-8
pmc: PMC7955928
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
100229Informations de copyright
© 2021.
Déclaration de conflit d'intérêts
The authors declare no competing interests.