Early Bacterial Coinfections in Patients Admitted to the ICU With COVID-19 or Influenza: A Retrospective Cohort Study

被引:8
作者
Bergmann, Felix [1 ,2 ]
Gabler, Cornelia [3 ]
Nussbaumer-Proell, Alina [1 ]
Woelfl-Duchek, Michael [1 ,4 ]
Blaschke, Amelie [1 ,5 ]
Radtke, Christine [2 ]
Zeitlinger, Markus [1 ]
Jorda, Anselm [1 ]
机构
[1] Med Univ Vienna, Dept Clin Pharmacol, Vienna, Austria
[2] Med Univ Vienna, Dept Plast Reconstruct & Aesthet Surg, Vienna, Austria
[3] Med Univ Vienna, IT Syst & Commun, Vienna, Austria
[4] Med Univ Vienna, Dept Biomed Imaging & Image Guided Therapy, Vienna, Austria
[5] Med Univ Vienna, Univ Clin Internal Med 1, Dept Infectiol & Trop Med, Vienna, Austria
关键词
bacterial superinfection; COVID-19; flu; intensive care unit; pneumonia; severe acute respiratory syndrome coronavirus 2; GUIDELINES;
D O I
10.1097/CCE.0000000000000895
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
IMPORTANCE:Previous findings suggest that bacterial coinfections are less common in ICU patients with COVID-19 than with influenza, but evidence is limited.OBJECTIVES:This study aimed to compare the rate of early bacterial coinfections in ICU patients with COVID-19 or influenza.DESIGN, SETTING AND PARTICIPANTS:Retrospective propensity score matched cohort study. We included patients admitted to ICUs of a single academic center with COVID-19 or influenza (January 2015 to April 2022).MAIN OUTCOMES AND MEASURES:The primary outcome was early bacterial coinfection (i.e., positive blood or respiratory culture within 2 d of ICU admission) in the propensity score matched cohort. Key secondary outcomes included frequency of early microbiological testing, antibiotic use, and 30-day all-cause mortality.RESULTS:Out of 289 patients with COVID-19 and 39 patients with influenza, 117 (n = 78 vs 39) were included in the matched analysis. In the matched cohort, the rate of early bacterial coinfections was similar between COVID-19 and influenza (18/78 [23%] vs 8/39 [21%]; odds ratio, 1.16; 95% CI, 0.42-3.45; p = 0.82). The frequency of early microbiological testing and antibiotic use was similar between the two groups. Within the overall COVID-19 group, early bacterial coinfections were associated with a statistically significant increase in 30-day all-cause mortality (21/68 [30.9%] vs 40/221 [18.1%]; hazard ratio, 1.84; 95% CI, 1.01-3.32).CONCLUSIONS AND RELEVANCE:Our data suggest similar rates of early bacterial coinfections in ICU patients with COVID-19 and influenza. In addition, early bacterial coinfections were significantly associated with an increased 30-day mortality in patients with COVID-19.
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页数:12
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