Risk stratification for selecting empiric antibiotherapy during and after COVID-19.
Journal
Current opinion in infectious diseases
ISSN: 1473-6527
Titre abrégé: Curr Opin Infect Dis
Pays: United States
ID NLM: 8809878
Informations de publication
Date de publication:
01 12 2022
01 12 2022
Historique:
pubmed:
28
9
2022
medline:
10
11
2022
entrez:
27
9
2022
Statut:
ppublish
Résumé
SARS-CoV-2 deeply modified the risk of bacterial infection, bacterial resistance, and antibiotic strategies. This review summarized what we have learned. During the COVID-19 pandemic, we observed an increase in healthcare-acquired infection and multidrug-resistant organism-related infection, triggered by several factors: structural factors, such as increased workload and ongoing outbreaks, underlying illnesses, invasive procedures, and treatment-induced immunosuppression. The two most frequently healthcare-acquired infections described in patients hospitalized with COVID-19 were bloodstream infection, related or not to catheters, health-acquired pneumonia (in ventilated or nonventilated patients). The most frequent species involved in bacteremia were Gram-positive cocci and Gram-negative bacilli in health-acquired pneumonia. The rate of Gram-negative bacilli is particularly high in late-onset ventilator-associated pneumonia, and the specific risk of Pseudomonas aeruginosa- related pneumonia increased when the duration of ventilation was longer than 7 days. A specificity that remains unexplained so far is the increase in enterococci bacteremia. The choice of empiric antibiotimicrobials depends on several factors such as the site of the infection, time of onset and previous length of stay, previous antibiotic therapy, and known multidrug-resistant organism colonization. Pharmacokinetics of antimicrobials could be markedly altered during SARS-CoV-2 acute respiratory failure, which should encourage to perform therapeutic drug monitoring.
Identifiants
pubmed: 36165454
doi: 10.1097/QCO.0000000000000881
pii: 00001432-202212000-00017
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
605-613Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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