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Bacterial, Fungal Coinfection Uncommon in COVID-19 Patients

Ninety-eight percent of patients received antibiotics at any point during COVID-19 hospitalization

FRIDAY, July 31, 2020 (HealthDay News) — Bacterial and fungal infections are uncommon in hospitalized COVID-19 patients, but coinfection is associated with high mortality and antibiotic use is widespread, according to a study published in the July issue of Infection Control & Hospital Epidemiology.

Priya Nori, M.D., from the Albert Einstein College of Medicine in Bronx, New York, and colleagues conducted a retrospective observational study of COVID-19 patients admitted between March 1, 2020, and April 18, 2020, to characterize the microbiology of bacterial and fungal coinfections during the pandemic surge.

The researchers identified bacterial or fungal coinfections in 152 of 4,267 COVID-19 patients (3.6 percent); mortality was 57 percent, while 16 percent of patients were discharged and 28 percent were still admitted at the time of analysis. Seventy-four percent of patients received mechanical ventilation. Overall, 91 (60 percent), 82 (54 percent), and 21 (14 percent) patients had positive respiratory cultures, positive blood cultures, and both positive blood and respiratory cultures, respectively. Nine percent of patients (13 patient) had polymicrobial cultures. Seventy-nine percent of patients had antibiotic exposure in the 30 days before positive microbiology. Ninety-eight percent of the study patients received antibiotics at any point during COVID-19 hospitalization; 107 patients (70 percent) received more than three antibiotic classes. Of 5,853 COVID-19 patients admitted between March 1 and May 31, 2020, 71 percent received at least one antibiotic dose.

“The pandemic has highlighted the need for close collaboration between stewardship and infection prevention programs to monitor for nosocomial infections, excess antibiotic use and multidrug resistance,” the authors write.

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