Bacterial pulmonary superinfections are associated with longer duration of ventilation in critically ill COVID-19 patients

Cell Reports Medicine

Annelies S. Zinkernagel¹  Pascal M. Frey²  Silvio D. Brugger³  Martina A. Maibach⁴  Alejandro Gómez-Mejia⁴  Srikanth Mairpady Shambat⁴  Daniel A. Hofmaenner⁴  Federica Andreoni⁴  Pedro David Wendel Garcia⁵  Jan Bartussek⁵  Reto A. Schuepbach⁵  Matthias P. Hilty⁵  Philipp K. Buehler⁵  Claudio T. Acevedo⁵ 

[1] Corresponding author;Department of Quantitative Biomedicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;Institute of Intensive Care Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;

关键词: severe acute respiratory syndrome coronavirus 2;    SARS-CoV-2;    coronavirus disease 19;    COVID-19;    acute respiratory distress syndrome;    ARDS;   

DOI  :  

来源: DOAJ

【 摘 要 】

Summary: 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.

【 授权许可】

Unknown