BACKGROUND AND OBJECTIVESHospital-acquired infections are one of the concerns of medical centers. The risk of bacterial infections in hospital intensive care units has increased with the spread of the coronavirus. The aim of this study is to investigate the prevalence of bacterial infections and evaluate antibiotic resistance in sputum samples obtained from hospitalized and outpatient individuals during the
COVID-۱۹ pandemic.MATERIALS AND METHODSThe identification of bacteria in sputum samples was carried out through gram staining, specific culture media (EMB and blood agar), and biochemical tests on patients admitted to Kosar and Sina Hospital in Semnan, Iran, from September ۲۰۲۰ to September ۲۰۲۲. A comprehensive investigation was conducted to assess the susceptibility of the bacteria to ۳۷ different antibiotics.RESULTS AND DISCUSSIONAmong the ۱۰۰ admitted patients, ۵۱% were female. The mean age of the patients was ۵۱.۵ years. Out of the ۴۹ patients diagnosed with bacterial infection, ۳۸ were specifically admitted to the intensive care unit and coronary care unit. Furthermore, ۵۴% of the patients in the study were found to be infected with COVID-۱۹. Among the identified infections, ۷۵.۵% were caused by gram-negative bacteria. A total of ۱۰ different bacteria were identified, with Acinetobacter (۲۴.۴%) and Klebsiella (۲۲.۴%) being the most prevalent, while Citrobacter and Escherichia coli (۲%) were found to be the least common.TE, CP, SXT, GM, FOX, CRO, MEN and FEP antibiotics were the most commonly used and the resistance rate was ۴۰-۵۰%. The highest levels of antibiotic resistance were observed in Pseudomonas ۸۶% (TE>SXT/TIC>V/CC/FM/SAM/FOX/CZ), Enterobacter ۸۰% (CZ>V/CC/SAM/FOX> V/OX/RA/S/AM), Acinetobacter ۶۹% (CZ>CRO >MEN/FEP/FOX> CP/TE>SXT), and Klebsiella ۳۶% (SAM>CZ> FOX/CRO/SXT> MEN/FEP/CP) when gram-negative bacteria were co-infected with coronavirus. Also, when infected with gram-positive bacteria and coronavirus, the highest levels of antibiotic resistance were found in S. epidermidis ۷۵% (OX>AZM>TE/CP/CC/CM/SXT) and Streptococcus ۶۰% (SXT>S>CP). No statistically significant association was found between co-infection with bacterial infections and COVID-۱۹.CONCLUSIONPatients who were admitted to intensive care units with
COVID-۱۹ displayed increased vulnerability to healthcare-associated infections caused by antibiotic-resistant bacteria. Insufficient and prompt medical care in patients who experienced co-infection with pathogenic microorganisms resulted in fatal outcomes, exacerbating the situation due to the presence of antibiotic resistance in these microorganisms.