Investigating the Prevalence of Bacterial Infections in Patients with Coronavirus Disease 2019 Hospitalized in Intensive Care Unit and Determining their Antibiotic Resistance Patterns

Somaye Shiralizadeh; Masoud Azimzadeh; Fariba Keramat; Seyyed Hamid Hashemi; Mohammad Mehdi Majzoobi; Mohammad Reza Arabestani; Farid Azizi Jalilian; Abbas Taher; Salman Khazaei; Mohammad Sina Alikhani; Pezhman Karami; Zahra Rahimi; Zahra Karimi Tabar; Masoud Moghaddam Shakib; Mohammad Yousef Alikhani

doi:10.2174/0118715265338445241007092436

Investigating the Prevalence of Bacterial Infections in Patients with Coronavirus Disease 2019 Hospitalized in Intensive Care Unit and Determining their Antibiotic Resistance Patterns

Infect Disord Drug Targets. 2024 Nov 8. doi: 10.2174/0118715265338445241007092436. Online ahead of print.

Authors

Somaye Shiralizadeh¹, Masoud Azimzadeh¹, Fariba Keramat^{2

3}, Seyyed Hamid Hashemi^{2

3}, Mohammad Mehdi Majzoobi^{2

3}, Mohammad Reza Arabestani^{1

3}, Farid Azizi Jalilian⁴, Abbas Taher⁵, Salman Khazaei⁶, Mohammad Sina Alikhani⁷, Pezhman Karami¹, Zahra Rahimi¹, Zahra Karimi Tabar¹, Masoud Moghaddam Shakib¹, Mohammad Yousef Alikhani¹

Affiliations

¹ Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran.
² Department of Infectious Diseases, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran.
³ Infectious Disease Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran.
⁴ Department of Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran.
⁵ Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran.
⁶ Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran.
⁷ Students Research Committee, Urmia University of Medical Sciences, Urmia, IR Iran.

PMID: 39528453
DOI: 10.2174/0118715265338445241007092436

Abstract

Background: COVID-19 patient hospitalization, particularly in intensive care units, exposes them to bacterial and fungi co-infections, which can have very serious consequences, including increased mortality. In addition, antibiotic resistance among pathogens is a hidden threat behind COVID-19.

Methods: In the period from 2020 September to 2021 August, bacterial isolates from COVID-19 patients admitted to the ICU of Sina Hospital in Hamadan, Iran, were collected and identified based on standard biochemical tests. COVID-19 cases were confirmed based on clinical symptoms, computed tomography, and polymerase chain reaction. Antimicrobial susceptibility tests were conducted using disc diffusion and broth microdilution methods.

Results: In total, 207 bacterial isolates were collected, with Klebsiella pneumoniae account-ing for 69 (33.33%) and Acinetobacter baumannii accounting for 59 (28.15%). The frequency and percentage of isolated bacteria were as follows: Alcaligenes species 28 (13.59%), Staphylococcus aureus 18 (8.73%), Pseudomonas aeruginosa 15 (7.28%), Escherichia coli 11 (5.33%), Stenotrophomonas maltophilia 3 (1.45%), Enterococcus species 3 (1.45%), and Serratia species 1 (0.48%). About 95.38% resistance to ceftazidime and cefotaxime and 92.31% resistance to ciprofloxacin and cefepime were found in K. pneumoniae isolates. A. baumannii isolates were 100% resistant to cefotaxime, ceftriaxone, and cefepime. About 22.22% resistance to vancomycin and 66.67% resistance to clindamycin, erythromycin, and cefoxitin were seen in S. aureus isolates.

Conclusion: Knowledge of bacterial co-infections and their antibiotic resistance pattern in COVID-19 patients can help in choosing effective antibiotics for the treatment and prevention of antibiotic resistance.

Keywords: COVID-19; Co-infections; antibiotic resistance; hospitalization.; intensive care units.