Dataset Information

Fungal and bacterial co-infections of the respiratory tract among patients with COVID-19 hospitalized in intensive care units.

ABSTRACT:

Backgrounds

The pandemic of COVID-19 has created a global public health crisis. ICU patients with COVID-19 are prone to infections of bacterial and/or fungal origins due to several risk factors. Consequently, the current study was conducted to evaluate the frequency, demographic characteristics, underlying conditions, and etiologic agents of fungal and bacterial co-infections of the respiratory tract among ICU patients with COVID-19 in Iran.

Materials and methods

From May to October 2020, sputa and endotracheal aspirates were collected from ICU patients hospitalized with COVID-19 who also were suspected of bacterial and/or fungal co-infections according to inclusion criteria. The etiologic agents of bacterial co-infections were identified using the Vitek 2 identification method. For fungal identification, all samples were analyzed by direct microscopy using KOH 10% and culture. Furthermore, all isolates were subjected to sequencing method.

Results

A total of 73 lung specimens were obtained from patients who met the inclusion criteria. Of these, in 15 cases (20.54%) fungal and/or bacterial co-infections were confirmed. Males were more infected (73.33%) and all of them were between 49 and 79 years. Candida albicans (n = 8, 61.53%) and Klebsiella pneumoniae (n = 5, 38.46%) were the most frequent etiologic agents related to fungal and bacterial co-infections, respectively. Pneumonia (n = 15, 100%) and diabetes mellitus (n = 8, 53.33%) were documented as the most prevalent underlying conditions. In the current study, 3 out of 15 patients (20%) died.

Conclusion

The frequency of bacterial co-infections of the respiratory tract in ICU patients hospitalized with COVID-19 was relatively high. According to the results, one of the causes of death of these patients could be a secondary infection.

SUBMITTER: Rafat Z

PROVIDER: S-EPMC8902060 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Fungal and bacterial co-infections of the respiratory tract among patients with COVID-19 hospitalized in intensive care units.

Rafat Zahra Z Ramandi Alireza A Khaki Pegah Afarinesh PA Ansari Saham S Ghaderkhani Sara S Haidar Hassan H Tajari Faezeh F Roostaei Davoud D Ghazvini Roshanak Daei RD Hashemi Seyed Jamal SJ Abdollahi Alireza A Kamali Sarvestani Hasti H

Gene reports 20220308

<h4>Backgrounds</h4>The pandemic of COVID-19 has created a global public health crisis. ICU patients with COVID-19 are prone to infections of bacterial and/or fungal origins due to several risk factors. Consequently, the current study was conducted to evaluate the frequency, demographic characteristics, underlying conditions, and etiologic agents of fungal and bacterial co-infections of the respiratory tract among ICU patients with COVID-19 in Iran.<h4>Materials and methods</h4>From May to Octob ...[more]

PMID: 35281669

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Project description:BACKGROUND:While influenza-like-illness (ILI) surveillance is well-organized at primary care level in Europe, few data are available on more severe cases. With retrospective data from intensive care units (ICU) we aim to fill this current knowledge gap. Using multiple parameters proposed by the World Health Organization we estimate the burden of severe acute respiratory infections (SARI) in the ICU and how this varies between influenza epidemics. METHODS:We analyzed weekly ICU admissions in the Netherlands (2007-2016) from the National Intensive Care Evaluation (NICE) quality registry (100% coverage of adult ICUs in 2016; population size 14 million) to calculate SARI incidence, SARI peak levels, ICU SARI mortality, SARI mean Acute Physiology and Chronic Health Evaluation (APACHE) IV score, and the ICU SARI/ILI ratio. These parameters were calculated both yearly and per separate influenza epidemic (defined epidemic weeks). A SARI syndrome was defined as admission diagnosis being any of six pneumonia or pulmonary sepsis codes in the APACHE IV prognostic model. Influenza epidemic periods were retrieved from primary care sentinel influenza surveillance data. RESULTS:Annually, an average of 13% of medical admissions to adult ICUs were for a SARI but varied widely between weeks (minimum 5% to maximum 25% per week). Admissions for bacterial pneumonia (59%) and pulmonary sepsis (25%) contributed most to ICU SARI. Between the eight different influenza epidemics under study, the value of each of the severity parameters varied. Per parameter the minimum and maximum of those eight values were as follows: ICU SARI incidence 558-2400 cumulated admissions nationwide, rate 0.40-1.71/10,000 inhabitants; average APACHE score 71-78; ICU SARI mortality 13-20%; ICU SARI/ILI ratio 8-17 cases per 1000 expected medically attended ILI in primary care); peak-incidence 101-188 ICU SARI admissions in highest-incidence week, rate 0.07-0.13/10,000 population). CONCLUSIONS:In the ICU there is great variation between the yearly influenza epidemic periods in terms of different influenza severity parameters. The parameters also complement each other by reflecting different aspects of severity. Prospective syndromic ICU SARI surveillance, as proposed by the World Health Organization, thereby would provide insight into the severity of ongoing influenza epidemics, which differ from season to season.

Project description:IntroductionFungal respiratory infections are being recognized with increasing frequency in parallel with an expanding population of immunocompromised patients. In most cases, colonization is the first step in the progression to pulmonary fungal infection. This study was designed to evaluate the distribution of fungal elements in the respiratory tract of symptomatic patients hospitalized in pulmonary units.MethodsThis descriptive cross-sectional study was carried out over a period of two years, from October 2017 to October 2019 in Guilan province, located in Iran's northern region. In the current study, bronchoalveolar lavage or sputum specimens were collected. All samples were analyzed by direct microscopy using KOH 10% and culture. Fungal identification was accomplished by internal transcribed spacer (ITS) and beta-tubulin sequencing. Also, in patients suspected of invasive pulmonary aspergillosis, BAL specimens were tested for galactomannan (GM) antigen.ResultsA total of 384 lung specimens (192 bronchoalveolar lavage (BAL) and 192 sputum samples) were obtained from symptomatic patients hospitalized in pulmonary units. Of these, 137 (35.67%) were positive in direct examination and culture. Among the 137 positive cases, most isolates were from male patients 86 (62.77%) and most of them were between 46 and 72 years. Candida albicans (37.22%) and Candida tropicalis (21.89%) represent the two most commonly isolated species in the current study. Cough (94.16%), dyspnea (81.02%), purulent sputum (62.04%) and weight loss (56.2%) were the predominant symptoms and tuberculosis (24.81%), chemotherapy (21.89%) and diabetes mellitus (19.70%) were the predominant underlying conditions. Also, 5 cases of invasive pulmonary aspergillosis and 1 case of mucormycosis were diagnosed.ConclusionCandida albicans was the most common fungal species isolated from symptomatic patients hospitalized in pulmonary units. Tuberculosis, chemotherapy and diabetes mellitus were important underlying conditions for pulmonary fungal colonization and/or infection.

Dataset Information

Fungal and bacterial co-infections of the respiratory tract among patients with COVID-19 hospitalized in intensive care units.

Backgrounds

Materials and methods

Results

Conclusion

Publications

Fungal and bacterial co-infections of the respiratory tract among patients with COVID-19 hospitalized in intensive care units.

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