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01-12-2021 | Macrolide | Research

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

Authors: Alejandro David Bendala Estrada, Jorge Calderón Parra, Eduardo Fernández Carracedo, Antonio Muiño Míguez, Antonio Ramos Martínez, Elena Muñez Rubio, Manuel Rubio-Rivas, Paloma Agudo, Francisco Arnalich Fernández, Vicente Estrada Perez, María Luisa Taboada Martínez, Anxela Crestelo Vieitez, Paula Maria Pesqueira Fontan, Marta Bustamante, Santiago J. Freire, Isabel Oriol-Bermúdez, Arturo Artero, Julián Olalla Sierra, María Areses Manrique, H. Francisco Javier Carrasco-Sánchez, Vanessa Carolina Vento, Gema María García García, Pablo Cubero-Morais, José-Manuel Casas-Rojo, Jesús Millán Núñez-Cortés

Published in: BMC Infectious Diseases | Issue 1/2021

Abstract

Background

Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection.

Methods

This work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality.

Results

Of 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21–1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64–0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often.

Conclusions

Bacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment.

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Wang Z, Yang B, Li Q, et al. Clinical features of 69 cases with coronavirus disease 2019 in Wuhan, China. Clin Infect Dis. 2020;71(15):769–77. https://doi.org/10.1093/cid/ciaa272.CrossRefPubMed

Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. JAMA. 2020;323:709–10. https://doi.org/10.1001/jama.2020.1097.CrossRefPubMed

World Health Organization. Coronavirus disease (COVID- 19) Situation Report. Accessed 05/31/2021, at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.

Casas-Rojo JM, Antón-Santos JM, Millán-Núñez-Cortés J, et al. Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Registry. Rev Clin Esp. 2020. https://doi.org/10.1016/j.rce.2020.07.003.CrossRefPubMedPubMedCentral

Situación de COVID-19 en España. Ministerio de Sanidad. Centro de Coordinación de Alertas y Emergencias Sanitarias. 2021. Accessed 05/31/2021, at https://cnecovid.isciii.es/covid19/.

Pal RK, Naik G, Rathore V, Sahu KK, Kumar R. Comparison between two different successful approaches to COVID-19 pandemic in India (Dharavi versus Kerala). J Family Med Prim Care. 2020;9(12):5827–32. https://doi.org/10.4103/jfmpc.jfmpc_1860_20.CrossRefPubMedPubMedCentral

Castro MC, Gurzenda S, Macário EM, França GVA. Characteristics, outcomes and risk factors for mortality of 522 167 patients hospitalised with COVID-19 in Brazil: a retrospective cohort study. BMJ Open. 2021;11(5): e049089. https://doi.org/10.1136/bmjopen-2021-049089.CrossRefPubMed

Weston S, Frieman MB. COVID-19: knowns, unknowns, and questions. mSphere. 2020;5(2):e00203-e220. https://doi.org/10.1128/mSphere.00203-20.CrossRefPubMedPubMedCentral

Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health, 2020, https://www.covid19treatmentguidelines.nih.gov/.

10.

Rawson TM, Moore LSP, Zhu N, et al. Bacterial and fungal co-infection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa530.CrossRefPubMed

11.

Quinton LJ, Walkey AJ, Mizgerd JP. Integrative physiology of pneumonia. Physiol Rev. 2018;98(3):1417–64. https://doi.org/10.1152/physrev.00032.2017.CrossRefPubMedPubMedCentral

12.

Deng JC. Viral-bacterial interactions-therapeutic implications. Influenza Other Respir Viruses. 2013;7(Suppl3):24–35. https://doi.org/10.1111/irv.12174.CrossRefPubMedPubMedCentral

13.

Yamada M, Suzuki H. Influenza virus pneumonia. Ryoikibetsu Shokogun Shirizu, 1999; (24 Pt 2):83–86.

14.

Ruuskanen O, Lahti E, Jennings LC, et al. Viral pneumonia. Lancet. 2011;377(9773):1264–75. https://doi.org/10.1016/S0140-6736(10)61459-6.CrossRefPubMedPubMedCentral

15.

Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45–67. https://doi.org/10.1164/rccm.201908-1581ST.CrossRefPubMedPubMedCentral

16.

Lee MS, Oh JY, Kang CI, et al. Guideline for antibiotic use in adults with community-acquired pneumonia. Infect Chemother. 2018;50(2):160–98. https://doi.org/10.3947/ic.2018.50.2.160.CrossRefPubMedPubMedCentral

17.

Feldman C, Anderson R. Antibiotic resistance of pathogens causing community-acquired pneumonia. Semin Respir Crit Care Med. 2012;33(3):232–43. https://doi.org/10.1055/s-0032-1315635.CrossRefPubMed

18.

Van Duin D, Paterson DL. Multidrug-resistant bacteria in the community: trends and lessons learned. Infect Dis Clin North Am. 2016;30(2):377–90. https://doi.org/10.1016/j.idc.2016.02.004.CrossRefPubMedPubMedCentral

19.

Karampela I, Dalamaga M. Could respiratory fluoroquinolones, levofloxacin and moxifloxacin, prove to be beneficial as an adjunct treatment in COVID-19? Arch Med Res. 2020. https://doi.org/10.1016/j.arcmed.2020.06.004.CrossRefPubMedPubMedCentral

20.

Novy E, Scala-Bertola J, Roger C, et al. Preliminary therapeutic drug monitoring data of β-lactams in critically ill patients with SARS-CoV-2 infection. Anaesth Crit Care Pain Med. 2020;39(3):387–8. https://doi.org/10.1016/j.accpm.2020.04.005.CrossRefPubMedPubMedCentral

21.

Pani A, Lauriola M, Romandini A, et al. Macrolides and viral infections: focus on azithromycin in COVID-19 pathology. Int J Antimicrob Agents. 2020;56(2): 106053. https://doi.org/10.1016/j.ijantimicag.2020.106053.CrossRefPubMedPubMedCentral

22.

Min JY, Jang YJ. Macrolide therapy in respiratory viral infections. Mediators Inflamm. 2012;2012: 649570. https://doi.org/10.1155/2012/649570.CrossRefPubMedPubMedCentral

23.

Ohe M, Shida H, Jodo S, et al. Macrolide treatment for COVID-19: will this be the way forward? Biosci Trends. 2020;14(2):159–60. https://doi.org/10.5582/bst.2020.03058.CrossRefPubMed

24.

Bosseboeuf E, Aubry M, Nhan T, et al. Azithromycin Inhibits the replication of Zika virus. J Antivir Antiretrovir. 2018;10(1):6–11. https://doi.org/10.4172/1948-5964.1000173.CrossRef

25.

Tran DH, Sugamata R, Hirose T, et al. Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1)pdm09 virus infection by interfering with virus internalization process. J Antibiot (Tokyo). 2019;72(10):759–68. https://doi.org/10.1038/s41429-019-0204-x.CrossRef

26.

Huttner BD, Catho G, Pano-Pardo JR, et al. COVID-19: don’t neglect antimicrobial stewardship principles. Clin Microbiol Infect. 2020;26(7):808–10. https://doi.org/10.1016/j.cmi.2020.04.024.CrossRefPubMedPubMedCentral

27.

Baron SA, Devaux C, Colson P, et al. Teicoplanin: An alternative drug for the treatment of coronavirus COVID-19? Int J Antimicrob Agents. 2020;55(4): 105944. https://doi.org/10.1016/j.ijantimicag.2020.105944.CrossRefPubMedPubMedCentral

28.

Du Y, Tu L, Zhu P, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: a retrospective observational study. Am J Respir Crit Care Med. 2020;201(11):1372–9. https://doi.org/10.1164/rccm.202003-0543OC.CrossRefPubMedPubMedCentral

29.

Zhang J, Zhou L, Yang Y, et al. Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics. Lancet Respir Med. 2020;8(3):e11–2. https://doi.org/10.1016/S2213-2600(20)30071-0.CrossRefPubMedPubMedCentral

30.

Kim D, Quinn J, Pinsky B, et al. Rates of co-infection between SARS-CoV-2 and other respiratory pathogens. JAMA. 2020;323(20):2085–6. https://doi.org/10.1001/jama.2020.6266.CrossRefPubMedPubMedCentral

31.

Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20. https://doi.org/10.1056/NEJMoa2002032 (Epub 2020 Feb 28).CrossRefPubMed

32.

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62. https://doi.org/10.1016/S0140-6736(20)30566-3.CrossRefPubMedPubMedCentral

33.

Wu J, Liu J, Zhao X, et al. Clinical characteristics of imported cases of Coronavirus Disease 2019 (COVID-19) in Jiangsu province: a Multicenter Descriptive Study. Clin Infect Dis. 2020;71(15):706–12. https://doi.org/10.1093/cid/ciaa199.CrossRefPubMed

34.

Argenziano MG, Bruce SL, Slater CL, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ. 2020;369: m1996. https://doi.org/10.1136/bmj.m1996.CrossRefPubMedPubMedCentral

35.

Suleyman G, Fadel RA, Malette KM, et al. Clinical characteristics and morbidity associated with coronavirus disease 2019 in a series of patients in metropolitan Detroit. JAMA Netw Open. 2020;3(6): e2012270. https://doi.org/10.1001/jamanetworkopen.2020.12270.CrossRefPubMedPubMedCentral

36.

Langford BJ, So M, Raybardhan S, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020. https://doi.org/10.1016/j.cmi.2020.07.016.CrossRefPubMedPubMedCentral

37.

Beović B, Dousak M, Ferreira-Coimbra J, et al. Antibiotic use in patients with COVID-19: a ‘snapshot’ Infectious Diseases International Research Initiative (ID-IRI) survey. J Antimicrob Chemother. 2020. https://doi.org/10.1093/jac/dkaa326.CrossRefPubMed

38.

Rawson TM, Ming D, Ahmad R, et al. Antimicrobial use, drug-resistant infections and COVID-19. Nat Rev Microbiol. 2020;18(8):409–10. https://doi.org/10.1038/s41579-020-0395-y.CrossRefPubMedPubMedCentral

39.

Mirzaei R, Goodarzi P, Asadi M, et al. Bacterial co-infections with SARS-CoV-2. IUBMB Life. 2020. https://doi.org/10.1002/iub.2356.10.1002/iub.2356.CrossRefPubMedPubMedCentral

40.

Abelenda-Alonso G, Rombauts A, Gudiol C, et al. Influenza and bacterial coinfection in adults with community-acquired pneumonia admitted to conventional wards: risk factors, clinical features, and outcomes. Open Forum Infect Dis. 2020;7(3):ofaa066. https://doi.org/10.1093/ofid/ofaa066.CrossRefPubMedPubMedCentral

41.

Smith AM, McCullers JA. Secondary bacterial infections in influenza virus infection pathogenesis. Curr Top Microbiol Immunol. 2014;385:327–56. https://doi.org/10.1007/82_2014_394.CrossRefPubMedPubMedCentral

42.

Jia L, Xie J, Zhao J, et al. Mechanisms of severe mortality-associated bacterial co-infections following influenza virus infection. Front Cell Infect Microbiol. 2017;7:338. https://doi.org/10.3389/fcimb.2017.00338.CrossRefPubMedPubMedCentral

43.

Katsurada N, Suzuki M, Aoshima M, et al. The impact of virus infections on pneumonia mortality is complex in adults: a prospective multicentre observational study. BMC Infect Dis. 2017;17(1):755. https://doi.org/10.1186/s12879-017-2858-y.CrossRefPubMedPubMedCentral

44.

Quah J, Jiang B, Tan PC, et al. Impact of microbial Aetiology on mortality in severe community-acquired pneumonia. BMC Infect Dis. 2018;18(1):451. https://doi.org/10.1186/s12879-018-3366-4.CrossRefPubMedPubMedCentral

45.

Morris DE, Cleary DW, Clarke SC. Secondary bacterial infec-tions associated with influenza pandemics. Front Microbiol. 2017;8:1041. https://doi.org/10.3389/fmicb.2017.01041.CrossRefPubMedPubMedCentral

46.

Webb SA, Pettilä V, Seppelt I, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009;361(20):1925–34. https://doi.org/10.1056/NEJMoa0908481.CrossRefPubMed

47.

Cillóniz C, Ewig S, Menéndez R, et al. Bacterial co-infection with H1N1 infection in patients admitted with community acquired pneumonia. J Infect. 2012;65(3):223–30. https://doi.org/10.1016/j.jinf.2012.04.009.CrossRefPubMedPubMedCentral

48.

Rice TW, Rubinson L, Uyeki TM, et al. Critical illness from 2009 pandemic influenza A virus and bacterial coinfection in the United States. Crit Care Med. 2012;40(5):1487–98. https://doi.org/10.1097/CCM.0b013e3182416f23.CrossRefPubMedPubMedCentral

49.

A tool for the potential fall 2009 wave of pandemic H1N1 to guide public health decision-making: An overview of the Public Health Agency of Canada’s planning considerations, September 2009. Can Commun Dis Rep. 2010; 36(Suppl 3): 1–20. https://doi.org/10.14745/ccdr.v36i00as3.

50.

Zahariadis G, Gooley TA, Ryall P, et al. Risk of ruling out severe acute respiratory syndrome by ruling in another diagnosis: variable incidence of atypical bacteria coinfection based on diagnostic assays. Can Respir J. 2006;13(1):17–22. https://doi.org/10.1155/2006/862797.CrossRefPubMedPubMedCentral

51.

Johansson N, Kalin M, Hedlund J. Clinical impact of combined viral and bacterial infection in patients with community-acquired pneumonia. Scand J Infect Dis. 2011;43(8):609–15. https://doi.org/10.3109/00365548.2011.570785.CrossRefPubMed

52.

Bezerra PGM, Britto MCA, Correia JB, et al. Viral and atypical bacterial detection in acute respiratory infection in children under five years. PLoS ONE. 2011;6(4): e18928. https://doi.org/10.1371/journal.pone.0018928.CrossRefPubMedPubMedCentral

53.

Crotty MP, Meyers S, Hampton N, et al. Epidemiology, co-infections, and outcomes of viral pneumonia in adults: an observational cohort study. Medicine (Baltimore). 2015;94(50): e2332. https://doi.org/10.1097/MD.0000000000002332.CrossRef

54.

Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–81. https://doi.org/10.1016/S2213-2600(20)30079-5.CrossRefPubMedPubMedCentral

55.

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan. China Lancet. 2020;395(10223):497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.CrossRefPubMed

56.

Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13. https://doi.org/10.1016/S0140-6736(20)30211-7.CrossRefPubMedPubMedCentral

57.

Bordi L, Nicastri E, Scorzolini L, et al. Differential diagnosis of illness in patients under investigation for the novel coronavirus (SARS-CoV-2), Italy, February 2020. Euro Surveill. 2020;25(8):2000170. https://doi.org/10.2807/1560-7917.ES.2020.25.8.2000170.CrossRefPubMedCentral

58.

World Health Organization. Clinical management of COVID-19 interim guidance [Internet].Geneva, Switzerland: WorldHealthOrganization; 2020. https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.

59.

Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020;46(5):854–87. https://doi.org/10.1007/s00134-020-06022-5.CrossRefPubMedPubMedCentral

60.

Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425–34. https://doi.org/10.1016/S1473-3099(20)30086-4.CrossRefPubMedPubMedCentral

61.

Klein EY, Monteforte B, Gupta A, et al. The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. Influenza Other Respir Viruses. 2016;10(5):394–403. https://doi.org/10.1111/irv.12398.CrossRefPubMedPubMedCentral

62.

Richter S, Parolin C, Palumbo M, et al. Antiviral properties of quinolone-based drugs. Curr Drug Targets Infect Disord. 2004;4(2):111–6. https://doi.org/10.2174/1568005043340920.CrossRefPubMed

63.

Marciniec K, Beberok A, Boryczka S, et al. Ciprofloxacin and moxifloxacin could interact with SARS-CoV-2 protease: preliminary in silico analysis (3/23/2020). https://doi.org/10.2139/ssrn.3562475.

64.

Garcia-Vidal C, Sanjuan G, Moreno-Garcia E, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect. 2020. https://doi.org/10.1016/j.cmi.2020.07.041.CrossRefPubMedPubMedCentral

65.

Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33. https://doi.org/10.1056/NEJMoa2001017.CrossRefPubMedPubMedCentral

66.

Liang WH, Guan WJ, Li CC, et al. Clinical characteristics and outcomes of hospitalised patients with COVID-19 treated in Hubei (epicentre) and outside Hubei (non-epicentre): a nationwide analysis of China. Eur Respir J. 2020;55(6):2000562. https://doi.org/10.1183/13993003.00562-2020.CrossRefPubMedPubMedCentral

67.

Randomised Evaluation of COVID-19 Therapy (RECOVERY Trial). Principal investigator: Peter W Horby. University of Oxford. ClinicalTrials.gov number NCT04381936; ISR number 50189673.

68.

Touret F, Gilles M, Barral K, et al. In vitro screening of a FDA approved chemical library reveals potential inhibitors of SARS-CoV-2 replication. Sci Rep. 2020;10(1):13093. https://doi.org/10.1038/s41598-020-70143-6.CrossRefPubMedPubMedCentral

69.

Gautret P, Lagier JC, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56(1): 105949. https://doi.org/10.1016/j.ijantimicag.2020.105949.CrossRefPubMedPubMedCentral

70.

Bengoechea JA, Bamford CG. SARS-CoV-2, bacterial co-infections, and AMR: the deadly trio in COVID-19? EMBO Mol Med. 2020;12(7): e12560. https://doi.org/10.15252/emmm.202012560.CrossRefPubMedPubMedCentral

71.

Hendaus MA, Jomha FA. Covid-19 induced superimposed bacterial infection. J Biomol Struct Dyn. 2020. https://doi.org/10.1080/07391102.2020.1772110.CrossRefPubMedPubMedCentral

72.

Rawson TM, Moore LSP, Castro-Sanchez E, et al. COVID-19 and the potential long-term impact on antimicrobial resistance. J Antimicrob Chemother. 2020;75(7):1681–4. https://doi.org/10.1093/jac/dkaa194.CrossRefPubMed

73.

Sharland M, Pulcini C, Harbarth S, et al. Classifying antibiotics in the WHO essential medicines list for optimal use-be AWaRe. Lancet Infect Dis. 2018;18(1):18–20. https://doi.org/10.1016/S1473-3099(17)30724-7.CrossRefPubMed

74.

Mayi BS, Mainville M, Altaf R, Lanspa M, Vaniawala S, Ollerhead TA, Raja A. A crucial role for antimicrobial stewardship in the midst of COVID-19. J Microbiol Biol Educ. 2021. https://doi.org/10.1128/jmbe.v22i1.2285.CrossRefPubMedPubMedCentral

75.

Sehgal K, Fadel HJ, Tande AJ, Pardi DS, Khanna S. Outcomes in patients with SARS-CoV-2 and Clostridioides difficile coinfection. Infect Drug Resist. 2021;28(14):1645–8. https://doi.org/10.2147/IDR.S305349.CrossRef

Title: Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
Authors: Alejandro David Bendala Estrada
Jorge Calderón Parra
Eduardo Fernández Carracedo
Antonio Muiño Míguez
Antonio Ramos Martínez
Elena Muñez Rubio
Manuel Rubio-Rivas
Paloma Agudo
Francisco Arnalich Fernández
Vicente Estrada Perez
María Luisa Taboada Martínez
Anxela Crestelo Vieitez
Paula Maria Pesqueira Fontan
Marta Bustamante
Santiago J. Freire
Isabel Oriol-Bermúdez
Arturo Artero
Julián Olalla Sierra
María Areses Manrique
H. Francisco Javier Carrasco-Sánchez
Vanessa Carolina Vento
Gema María García García
Pablo Cubero-Morais
José-Manuel Casas-Rojo
Jesús Millán Núñez-Cortés
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Macrolide
Azithromycin
Antibiotic
SARS-CoV-2
COVID-19
Published in: BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-021-06821-1

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