Bacterial Superinfections in Covid-19: Circulating Strains and Outcome

Introduction: The COVID-19 pandemic caused by the new coronavirus has led to enormous pressure on health systems around the world, with an increase in the number of hospitalizations for pneumonia with a higher incidence of healthcare-associated infections (1).

Material and Method: We performed a retrospective analysis of 40 cases hospitalized in the first pandemic wave between March 2020-May 2020, addmited in the Intensive Care Unit of the Clinical Hospital for Infectious Diseases Constanta, including patients with a diagnosis of SARS-CoV-2 infection and Bacterial superinfection. Multiple parameters were analysed: clinical, biological, bacterial culture results, resistance profile of isolated strains, as well as patient’s evolution.

Results and Conclusions: In terms of patient profile, the average age was 62.3 years, with the male sex being the majority represented by a number of 30 cases (75%). All patients had associated comorbidities. The clinical picture presented by the patients was characteristic of severe forms of infection, with respiratory failure.

The observed bio-humoral changes characteristic of bacterial superinfections were found in all patients, leukocytosis with marked neutrophilia, significant biological inflammatory syndrome and positive procalcitonin.

During the period analysed we observed a significant increase in carbapenem-resistant strains. The resistant strains were represented by Klebsiella Pneumoniae found in 35 samples (54%), Acinetobacter Buamanni was isolated in 15 culture samples (23%). The antibiotic regimen used consisted of a combination of 2 or 3 classes of antibiotics depending on the resistance profile, monotherapy is not recommended in infections with multi-resistant germs. All patients required oxygen therapy, the average length of hospital stay was 28 days. Death was recorded in 10 cases (25%).