Evaluation of Blood culture and antimicrobial susceptibility pattern of bacteria isolated via VITEK۲ from Hospitalized Patients with severe COVID-۱۹

Background and Aim : Antibiotic-resistant bacterial infections are one of the leading causes of morbidity and mortality in hospitalized patients with viral respiratory infections. In this regard, the coincidence of the severe acute respiratory syndrome coronavirus ۲ (SARS-CoV-۲) pandemic with the global crisis of antibiotic resistance has complicated the problem. Methods : This retrospective descriptive study was conducted on patients with acute COVID-۱۹ who were hospitalized in the intensive care unit (ICU) of Imam Reza Hospital in Mashhad, Iran, during the three COVID-۱۹ peaks (between ۲۰۱۹ to ۲۰۲۰). The participants were chosen based on information found in the medical records of patients who were diagnosed with COVID-۱۹ by laboratory diagnostic tests and PCR tests between March ۲۰۱۹ and March ۲۰۲۰.Results : In general, the information of ۲۵ patients (۲۱ male and ۴ female) were gathered. Source of culture was blood ۱۰۰ % of patient (۲۵ patients). All patients suffered from severe COVID-۱۹. The identified agents isolated from patients were Gram-negative bacteria and (n=۱۲, ۴۶%) and Gram-positive bacteria (n=۱۳ ۵۴%). . Non-Fermenting Gram-Negative Bacterium (Pseudomonas aeruginosa, Acinetobacter baumannii complex, and Stenotrophomonas maltophilia) was observed in five cases. Based on the obtained results, three strains of Acinetobacter baumannii complex was extreme drug resistant (XDR) ,that was sensitive to Tigecycline and Colistin (MIC≤۰.۵). Pseudomonas aeruginosa was Carbapenemase-producing Enterobacteriaceae (CPE) , that was resistance to Meropenem and Imipenem at the concentration of ≥۱۶. Stenotrophomonas maltophilia was sensitive to Tigecycline amd Trimethoprim Sulfamethoxazole (MIC≤۲.۳۷). Among, gram- positive bacteria, two strains isolated from S. aureus was Methicillin-resistant S. aureus (MRSA) at the concentration of >۲ (Oxacillin), while Cefoxitin was sensitive to S. aureus. Enterococcus was Vancomycin-resistant Enterococcus (VRE) at the concentration of higher than ۴ (MIC≥۳۲). Conclusion : The serious and dangerous organisems including MRSA, VRE, VRSA, XDR acinetobacter baumannii, CPE have been isolated from clinical specimens of critical COVID-۱۹ patients. There are some evidences on the remarkable increase of various antibiotics MIC during COVID-۱۹ pandemic due to antibiotic-induced pressure towards mutations, which highlight the impact the use of steroids on the risk to develop during COVID-۱۹.

کلیدواژه ها:

COVID‐۱۹ ، Blood culture ، antimicrobial