The prevalence of coinfections and antibiotic-resistant strainsamong hospitalized Covid-۱۹ patients in Mashhad, Iran

Background and Aim : Patients with viral respiratory infections are prone to bacterialcoinfections, and such coinfections have a strong correlation with the severity of the complicationscaused by viral infections. Limited information is available on the prevalence of bacterialcoinfections among individuals infected with severe acute respiratory syndrome coronavirus ۲(SARS-CoV-۲). Furthermore, the management of empirical antibiotic guidelines could besignificantly influenced by the determination of the incidence of bacterial coinfections in Covid-۱۹ patients. Therefore, we aimed to evaluate the prevalence of bacterial coinfection among Covid-۱۹ patients and to determine their antibiotic sensitivity profiles. Infection with Candida was alsoassessed.Methods : This retrospective study includes the results of the evaluation of blood, respiratory, andurine samples that had been collected from ۴۶۰۹ Covid-positive patients admitted to Imam Rezahospital of Mashhad, Iran, in ۲۰۲۰ and ۲۰۲۱. A positive PCR test, as well as clinical determinationof infection with Covid-۱۹ by a physician, were the inclusion criteria for these infected patients.Results : Out of a total of ۱۱۵۹۰ samples, ۶۵۰۶ samples had been collected from men and ۵۰۸۴from women. Based on the assessment of the culture of the specimens, ۳۶۹۴ samples (۳۲%) weredetermined to have coinfections. ۴۴۴ samples were infected with Acinetobacter, ۴۱۲ withEnterococcus, ۳۷۵ with Klebsiella pneumoniae, ۳۵۳ with Escherichia coli, and ۱۰۱۴ with Candida.۳۱۶ samples contained multidrug resistant-Acinetobacter, ۱۸۷ contained multidrug resistant-Klebsiella pneumoniae, ۲۲۴ had ESBL-producing E. coli, and ۲۱۴ had vancomycin-resistantEnterococcus.Conclusion : According to our findings, the prevalence of bacterial and Candida coinfection washigh among Covid-۱۹ patients. The majority of the identified bacterial coinfections were relatedto gram-negative bacteria, including K. pneumoniae, which could have valuable implications indeveloping appropriate treatment plans. Moreover, the significant number of resistant bacterialstrains that were found among our samples shows the critical need for establishing a suitableantibiotic stewardship program. Given that the presence of coinfecting pathogens and resistantstrains contributes to morbidity and mortality rates among Covid-۱۹ patients, constant surveillanceof bacterial resistance and microbial coinfections is critical in controlling the pandemic.

کلیدواژه ها:

Coinfection ، Bacterial coinfections ، Covid-۱۹ ، Antibiotic resistance