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European Journal of Clinical Microbiology & Infectious Diseases

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Open Access 01-04-2021 | Aspergillus Fumigatus | Original Article

Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship

Authors: Kathrin Rothe, Susanne Feihl, Jochen Schneider, Fabian Wallnöfer, Milena Wurst, Marina Lukas, Matthias Treiber, Tobias Lahmer, Markus Heim, Michael Dommasch, Birgit Waschulzik, Alexander Zink, Christiane Querbach, Dirk H. Busch, Roland M. Schmid, Gerhard Schneider, Christoph D. Spinner

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 4/2021

Abstract

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Bacterial co-infections are associated with unfavourable outcomes in respiratory viral infections; however, microbiological and antibiotic data related to COVID-19 are sparse. Adequate use of antibiotics in line with antibiotic stewardship (ABS) principles is warranted during the pandemic. We performed a retrospective study of clinical and microbiological characteristics of 140 COVID-19 patients admitted between February and April 2020 to a German University hospital, with a focus on bacterial co-infections and antimicrobial therapy. The final date of follow-up was 6 May 2020. Clinical data of 140 COVID-19 patients were recorded: The median age was 63.5 (range 17–99) years; 64% were males. According to the implemented local ABS guidelines, the most commonly used antibiotic regimen was ampicillin/sulbactam (41.5%) with a median duration of 6 (range 1–13) days. Urinary antigen tests for Legionella pneumophila and Streptococcus peumoniae were negative in all cases. In critically ill patients admitted to intensive care units (n = 50), co-infections with Enterobacterales (34.0%) and Aspergillus fumigatus (18.0%) were detected. Blood cultures collected at admission showed a diagnostic yield of 4.2%. Bacterial and fungal co-infections are rare in COVID-19 patients and are mainly prevalent in critically ill patients. Further studies are needed to assess the impact of antimicrobial therapy on therapeutic outcome in COVID-19 patients to prevent antimicrobial overuse. ABS guidelines could help in optimising the management of COVID-19. Investigation of microbial patterns of infectious complications in critically ill COVID-19 patients is also required.

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Title: Rates of bacterial co-infections and antimicrobial use in COVID-19 patients: a retrospective cohort study in light of antibiotic stewardship
Authors: Kathrin Rothe
Susanne Feihl
Jochen Schneider
Fabian Wallnöfer
Milena Wurst
Marina Lukas
Matthias Treiber
Tobias Lahmer
Markus Heim
Michael Dommasch
Birgit Waschulzik
Alexander Zink
Christiane Querbach
Dirk H. Busch
Roland M. Schmid
Gerhard Schneider
Christoph D. Spinner
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Aspergillus Fumigatus
Antibiotic
Carbapenem Antibiotic
COVID-19
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 4/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-020-04063-8

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