Bacterial superinfection and antibiotic management in patients with COVID-19 admitted to intensive care medicine in central Iran: A follow-up study

Bacterial superinfections are one of the crucial challenges in patients with coronavirus disease 2019 (COVID‑19) that are associated with a high mortality rate. The current study was designed to assess bacterial superinfections and antibiotic management in COVID‑19 patients admitted to intensive care unit (ICU).

Seventy‑three adult intubated patients with COVID‑19 were included in a cross‑sectional study. The lung aspirate samples were collected in two stages and assessed for bacterial growth by standard methods. Antimicrobial susceptibility testing was performed using the Kirby‑Bauer method as recommended by the Clinical Laboratory Standard Institute guideline (2021 edition). Also, demographic and clinical data were collected. The statistical analysis was done by chisquare test and Student’s t-test, and a Pvalue <0.05 was considered significant.

Forty men and thirty‑three women with a mean age of 64.78 ± 13.90 have included in our study. The mean length of hospitalization and stay in ICU were 18.77 ± 12.94 and 13.51 ± 9.83 days, respectively; 84.9% of cases died. Thirty‑three patients had a bacterial superinfection mainly caused by Klebsiella spp and Acinetobacter spp; 21.2% of piperacillin/tazobactam consumers’ patients survived that; the differences were significant (p = 0.034). Asignificant relationship was seen between superinfection and length of hospital stay until intubation (p = 0.033).

Bacterial superinfection and mortality rates were relatively high in COVID‑19 patients admitted to ICU. According to the results, using beta‑lactam/beta‑lactamase inhibitors antibiotics in hospitalized patients in ICU can effectively control superinfection.