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Tytuł:
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An observational cohort study of bacterial co-infection and implications for empirical antibiotic therapy in patients presenting with COVID-19 to hospitals in North West London.
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Autorzy:
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Wang L; Department of Microbiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.
Amin AK; Department of Microbiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.; Faculty of Medicine, Imperial College London, London SW7 2BU, UK.
Khanna P; Department of Microbiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.; Faculty of Medicine, Imperial College London, London SW7 2BU, UK.
Aali A; Department of Microbiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.
McGregor A; Department of Microbiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.; Faculty of Medicine, Imperial College London, London SW7 2BU, UK.; Department of Infectious Diseases, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.
Bassett P; Statsconsultancy Ltd, 40 Longwood Lane, Amersham HP7 9EN, UK.
Gopal Rao G; Department of Microbiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK.; Faculty of Medicine, Imperial College London, London SW7 2BU, UK.
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Źródło:
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The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2021 Feb 11; Vol. 76 (3), pp. 796-803.
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Typ publikacji:
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Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 1997- : London : Oxford University Press
Original Publication: London, New York, Academic Press.
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MeSH Terms:
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Empirical Research*
COVID-19 Drug Treatment*
Anti-Bacterial Agents/*therapeutic use
Bacterial Infections/*drug therapy
Coinfection/*drug therapy
Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/diagnosis ; Bacterial Infections/epidemiology ; COVID-19/diagnosis ; COVID-19/epidemiology ; Cohort Studies ; Coinfection/diagnosis ; Coinfection/epidemiology ; Comorbidity ; Female ; Humans ; London/epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult
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Substance Nomenclature:
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0 (Anti-Bacterial Agents)
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Entry Date(s):
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Date Created: 20201113 Date Completed: 20210223 Latest Revision: 20221207
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Update Code:
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20240105
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PubMed Central ID:
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PMC7717240
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DOI:
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10.1093/jac/dkaa475
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PMID:
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33185241
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Objectives: To describe the prevalence and nature of bacterial co-infections in COVID-19 patients within 48 hours of hospital admission and assess the appropriateness of empirical antibiotic treatment they received.
Methods: In this retrospective observational cohort study, we included all adult non-pregnant patients who were admitted to two acute hospitals in North West London in March and April 2020 and confirmed to have COVID-19 infection within 2 days of admission. Results of microbiological specimens taken within 48 hours of admission were reviewed and their clinical significance was assessed. Empirical antibiotic treatment of representative patients was reviewed. Patient age, gender, co-morbidities, inflammatory markers at admission, admission to ICU and 30 day all-cause in-hospital mortality were collected and compared between patients with and without bacterial co-infections.
Results: Of the 1396 COVID-19 patients included, 37 patients (2.7%) had clinically important bacterial co-infection within 48 hours of admission. The majority of patients (36/37 in those with co-infection and 98/100 in selected patients without co-infection) received empirical antibiotic treatment. There was no significant difference in age, gender, pre-existing illnesses, ICU admission or 30 day all-cause mortality in those with and without bacterial co-infection. However, white cell count, neutrophil count and CRP on admission were significantly higher in patients with bacterial co-infections.
Conclusions: We found that bacterial co-infection was infrequent in hospitalized COVID-19 patients within 48 hours of admission. These results suggest that empirical antimicrobial treatment may not be necessary in all patients presenting with COVID-19 infection, although the decision could be guided by high inflammatory markers.
(© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
