Microbial landscape in hospital patients with new coronavirus disease (COVID-19), antibiotic resistance comparison vs. Pre-covid stage: a prospective study

Avdeeva, Marina G. and Kulbuzheva, Makka I. and Zotov, Sergey V. and Zhuravleva, Yelena V. and Yatsukova, Alina V. (2021) Microbial landscape in hospital patients with new coronavirus disease (COVID-19), antibiotic resistance comparison vs. Pre-covid stage: a prospective study. Kuban Scientific Medical Bulletin, 28 (5). pp. 14-28. ISSN 1608-6228

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Abstract

Background. The new coronavirus infection has manifested untypically compared to other acute respiratory agents, posing a major challenge to researchers worldwide. Despite low incidence of bacterial complications, microbial coinfection plays an important role in the onset and development of severe COVID-19 to hamper diagnosis, treatment and prognosis.

Objectives. A study of microbial landscape in secondary complications of COVID-19 and prevailing microbial-agent antibiotic resistance dynamics in COVID-19 vs. patients with pre-COVID community-acquired pneumonia.

Methods. We analysed 1,113 bacterial sputum cultures in COVID-19 patients from 21 hospital of Krasnodar Krai. The study sample comprised 524 strains isolated from COVID-19 patients in bacteriological assays. The comparison sample included 643 positive sputum strains isolated from community-acquired pneumonia patients developing disease in outcome of acute respiratory infection in 2015–2018. The microbial aetiology landscape and strain antibiotic resistance have been compared in COVID-19 vs. patients with community-acquired pneumonia.

Results. Gram-negative bacteria predominated in COVID-19 cultures (58%), followed by Gram-positive bacteria (15%) and fungi (27%). Acinetobacter baumannii (35%) and Klebsiella pneumoniae (33%) were about equally represented in Gram-negative flora, Pseudomonas aeruginosa (19%) and other microorganisms were half as common. Streptococcus pneumonia and Staphylococcus aureus accounted for 48 and 15% Gram-positive strains, respectively. Sputum-isolated fungi were mainly identifi ed as Candida albicans (89%). The Streptoccocus pneumoniae detection rate dropped to 7% in 2020 relative of other flora, which is 10 times less vs. pre-COVID rates, whilst the fungal rate increased dramatically. Antibiotic resistance increased in most isolated microbial strains.

Conclusion. A Gram-negative-dominated aetiology of lower respiratory tract lesions, as well as higher risk of fungal and other opportunistic coinfections should be taken into account in patient treatment for a complicated coronavirus infection. A higher antibiotic resistance is induced by active indication-ignorant use of antibiotics, including pre-hospital treatment. A suitable treatment regimen in COVID-19 should avoid undue antibiotic prescriptions in every patient.

Item Type: Article
Subjects: STM Open Press > Medical Science
Depositing User: Unnamed user with email support@stmopenpress.com
Date Deposited: 03 Mar 2023 09:16
Last Modified: 28 Aug 2024 13:03
URI: http://journal.submissionpages.com/id/eprint/539

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