Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: a multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ).
Antibiotic stewardship
Bacterial pathogens
COVID-19
Community-acquired co-infection
Rapid multiplex PCR diagnostic
Journal
Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
15
08
2021
accepted:
12
10
2021
pubmed:
24
10
2021
medline:
27
11
2021
entrez:
23
10
2021
Statut:
ppublish
Résumé
Thorough knowledge of the nature and frequency of co-infections is essential to optimize treatment strategies and risk assessment in cases of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the multiplex polymerase chain reaction (PCR) screening approach for community-acquired bacterial pathogens (CABPs) at hospital admission, which could facilitate identification of bacterial co-infections in hospitalized COVID-19 patients. Clinical data and biomaterials from 200 hospitalized COVID-19 patients from the observational cohort of the Competence Network for community-acquired pneumonia (CAPNETZ) prospectively recruited between March 17, 2020, and March 12, 2021 in 12 centers in Germany and Switzerland, were included in this study. Nasopharyngeal swab samples were analyzed on hospital admission using multiplex real-time reverse transcription (RT)-PCR for a broad range of CABPs. In total of 200 patients Staphylococcus aureus (27.0%), Haemophilus influenzae (13.5%), Streptococcus pneumoniae (5.5%), Moraxella catarrhalis (2.5%), and Legionella pneumophila (1.5%) were the most frequently detected bacterial pathogens. PCR detection of bacterial pathogens correlated with purulent sputum, and showed no correlation with ICU admission, mortality, and inflammation markers. Although patients who received antimicrobial treatment were more often admitted to the ICU and had a higher mortality rate, PCR pathogen detection was not significantly related to antimicrobial treatment. General CABP screening using multiplex PCR with nasopharyngeal swabs may not facilitate prediction or identification of bacterial co-infections in the early phase of COVID-19-related hospitalization. Most patients with positive PCR results appear to be colonized rather than infected at that time, questioning the value of routine antibiotic treatment on admission in COVID-19 patients.
Identifiants
pubmed: 34687426
doi: 10.1007/s15010-021-01720-8
pii: 10.1007/s15010-021-01720-8
pmc: PMC8536912
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1299-1306Investigateurs
M Dreher
(M)
C Cornelissen
(C)
W Knüppel
(W)
D Stolz
(D)
N Suttorp
(N)
P Creutz
(P)
A Mikolajewska
(A)
A le Claire
(A)
M Benzke
(M)
T Bauer
(T)
D Krieger
(D)
M Prediger
(M)
S Schmager
(S)
M Kolditz
(M)
B Schulte-Hubbert
(B)
S Langner
(S)
O Degen
(O)
A Hüfner
(A)
C Hoffmann
(C)
T Welte
(T)
J Freise
(J)
G Barten-Neiner
(G)
M Nawrocki
(M)
I Fuge
(I)
J Naim
(J)
W Kröner
(W)
T Illig
(T)
N Klopp
(N)
C Kroegel
(C)
A Moeser
(A)
B Schleenvoigt
(B)
C Forstner
(C)
D Drömann
(D)
P Parschke
(P)
K Franzen
(K)
J Rupp
(J)
N Käding
(N)
E Wouters
(E)
K Walraven
(K)
D Braeken
(D)
C Spinner
(C)
H Buschmann
(H)
A Zaruchas
(A)
T Schaberg
(T)
I Hering
(I)
W Albrich
(W)
F Waldeck
(F)
F Rassouli
(F)
S Baldesberger
(S)
M Panning
(M)
M Wallner
(M)
Informations de copyright
© 2021. The Author(s).
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