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    Incidence and Characteristics of Co-infection MESHD and Secondary Infection in Patients with COVID-19 MESHD

    Authors: Yingyi Guo; Lingling Cheng; Ningjing Liu; Tungngai Li; Ying Jiang; Qiao Wan; Chuyue Zhuo; Shunian Xiao; Baomo Liu; Yan Chen; lin Fu; Zhixu Chen; Mingcong Ma; Chao Zhuo; Nanshan Zhong

    doi:10.1101/2021.01.06.425542 Date: 2021-01-06 Source: bioRxiv

    ObjectiveThe etiology and epidemiology of co-infection MESHD and secondary infection in COVID-19 MESHD patients remain unknown. The study aims to investigate the occurrence and characteristics of co-infection MESHD and secondary infection in COVID-19 MESHD patients, mainly focusing on Streptococcus pneumoniae co-infections MESHD. MethodsThis study was a prospective, observational cohort study of the inpatients diagnosed with COVID-19 MESHD in two designated hospitals in south China enrolled between Jan 11 and Feb 22, 2020. The urine specimen was collected on admission and applied for pneumococcal urinary antigen tests (PUATs). Demographic, clinical and microbiological data of patients were recorded simultaneously. ResultA total of 146 patients with a confirm diagnosis of COVID-19 MESHD at the median age of 50.0 years (IQR 36.0-61.0) were enrolled, in which, 16 (11.0%) were classified as severe cases and 130 (89.0%) as non-severe cases. Of the enrolled patients, only 3 (2.1%) were considered to present the co-infection MESHD, in which 1 was co-infected MESHD with S.pneumoniae, 1 with B. Ovatus infection MESHD and the other one with Influenza A virus infection MESHD. Secondary infection MESHD occurred in 16 patients, with S. maltophilia MESHD as the most commonly isolated pathogen (43.8%), followed by P. aeruginosa (25.0%), E. aerogenes (25.0%), C. parapsilosis (25.0%) and A. fumigates (18.8%). ConclusionPatients with confirmed COVID-19 MESHD were rarely co-infected MESHD with Streptococcus pneumoniae or other pathogens, indicating that the application of antibiotics against CAP on admission may not be necessary in the treatment of COVID-19 MESHD cases.

    Bacteraemia Variation During The COVID-19 Pandemic MESHD; A Multi-Centre UK Secondary Care Ecological Analysis.

    Authors: Sarah Denny; Timothy M Rawson; Giovanni Satta; Scott JC Pallett; Ahmed Abdulaal; Stephen Hughes; Mark Gilchrist; Nabeela Mughal; Luke S P Moore

    doi:10.21203/rs.3.rs-113509/v1 Date: 2020-11-21 Source: ResearchSquare

    Objectives – We investigated for change in blood stream infections (BSI) with Enterobacterales, coagulase negative staphylococci (CoNS), Streptococcus pneumoniae, and Staphylococcus aureus during the first UK wave of SARS-CoV-2 across six London hospitals.Methods – A retrospective multicentre ecological analysis was undertaken evaluating all blood cultures taken from adults from 01 April 2017 to 30 April 2020 across six acute hospitals in London. Linear trend analysis and ARIMA models allowing for seasonality were used to look for significant variation.Results –119,584 blood cultures were included. At the height of the UK SARS-CoV-2 first wave in April 2020, Enterobacterales bacteraemias MESHD were at an historic low across two London trusts (63/3814, 1.65%), whilst CoNS were at an historic high (173/3814, 4.25%). This differed significantly for both Enterobacterales (p=0.013) and CoNS (p<0.01), when compared with prior periods, even allowing for seasonal variation. S. pneumoniae (p=0.631) and S. aureus (p=0.617) BSI did not vary significant throughout the study period.Conclusions – Significantly fewer than expected Enterobacteriales BSI occurred during the UK peak of the COVID-19 pandemic MESHD; identifying potential causes, including potential unintended consequences of national self-isolation public health messaging, is essential. High rates of CoNS BSI, presumably representing contamination associated with increased use of personal protective equipment, may result in inappropriate antimicrobial use and indicates a clear area for intervention during further waves.

    Secondary Infection in Severe and Critical COVID-19 MESHD Patients in China: A Multicenter Retrospective Study

    Authors: Ling Sang; Yin Xi; Zhimin Lin; Ying Pan; Bin Song; Chang-an Li; Xia Zheng; Ming Zhong; Li Jiang; Chun Pan; Wei Zhang; Zheng Lv; Jiaan Xia; Nanshan Chen; Wenjuan Wu; Yonghao Xu; Sibei Chen; Dongdong Liu; Weibo Liang; Xuesong Liu; Xiaoqing Liu; Shiyue Li; Nanshan Zhong; Dan Ye; Yuanda Xu; Nuofu Zhang; Dingyu Zhang; Yimin Li

    doi:10.21203/rs.3.rs-112099/v1 Date: 2020-11-19 Source: ResearchSquare

    Background. Since 2020 COVID-19 pandemic MESHD COVID-19 pandemic MESHD became an emergent public sanitary incident. The epidemiology data and the impact on prognosis of secondary infection MESHD in severe and critical COVID-19 MESHD patients in China remained largely unclear.Methods. We retrospectively reviewed medical records of all adult patients with laboratory-confirmed COVID-19 MESHD who were admitted to ICUs from January 18th 2020 to April 26th 2020 at two hospitals in Wuhan, China and one hospital in Guangzhou, China. We measured the frequency of bacteria and fungi cultured from respiratory tract, blood and other body fluid specimens. The risk factors for and impact of secondary infection on clinical outcomes were also assessed. Results. Secondary infections were very common (86.6%) when patients were admitted to ICU for >72 hours. The majority of infections were respiratory, with the most common organisms being Klebsiella pneumoniae MESHD (24.5%), Acinetobacter baumannii (21.8%), Stenotrophomonas maltophilia MESHD (9.9%), Candida albicans (6.8%), and Pseudomonas spp. (4.8%). Furthermore, the proportions of multidrug resistant (MDR) bacteria and carbapenem resistant Enterobacteriaceae (CRE) were high. We also found that age ≥60 years and mechanical ventilation ≥13days independently increased the likelihood of secondary infection. Finally, patients with positive cultures had reduced ventilator free days in 28 days and patients with CRE and/or MDR bacteria positivity showed lower 28 day survival rate.Conclusions. In a retrospective cohort of severe and critical COVID-19 MESHD patients admitted to ICUs in China, the prevalence of secondary infection was high, especially with CRE MESHD and MDR bacteria MESHD, resulting in poor clinical outcomes.

    Clinical Features and Risk Factors for Secondary Infection in Critically Ill Patients With COVID-19 MESHD

    Authors: Tongtong Pan; Dazhi Chen; Yi Chen; Chenwei Pan; Feifei Su; Liang Hong; Huili Li; Hui Zhao; Zhuo Lin; Xiaodong Wang; Hongwei Lin; Chao Cai; Yong-Ping Chen

    doi:10.21203/rs.3.rs-100708/v1 Date: 2020-10-30 Source: ResearchSquare

    Background: To analyze the clinical features and the possible risk factors of secondary infection, and explore their impact on prognosis of COVID-19 MESHD. Methods: A total of 165 severe and critical hospitalized patients diagnosed with COVID-19 MESHD were included. The clinical characteristics, laboratory tests, imaging data, secondary infections and outcomes were analyzed. Results: The mean age of total patients was (57.3±15.2) years, of which 111 were males (67.3%). 108 cases were with basic diseases (65.5%), and 1 death (0.6%). The secondary infection rate in critical patients was significantly higher than in severe patients (P <0.05). The secondary infections were mainly lung infections MESHD. The pathogens were principally Burkholderia multivorans, Stenotrophomonas maltophilia MESHD, Acinetobacter baumannii and Klebsiella pneumoniae MESHD. The recovery rate of 28 days in the infected group was significantly lower than that in the non-infected group (p < 0.001).The utilization rate and usage time of invasive ventilator, and deep vein catheterization, catheter indwelling and ECMO were the risk factors for the secondary infected MESHD patients.Conclusion: Secondary infection is an extremely common complication in critically ill patients and a trigger point for exacerbation of the disease. An effective control on the secondary infection will do good to the prognosis of COVID-19 MESHD patients.

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