Impact of respiratory bacterial infections on mortality in Japanese patients with COVID-19: a retrospective cohort study

被引：0

作者：

Nakagawara, Kensuke ^{[1
]}

Kamata, Hirofumi ^{[1
]}

Chubachi, Shotaro ^{[1
]}

Namkoong, Ho ^{[2
]}

Tanaka, Hiromu ^{[1
]}

Lee, Ho ^{[1
]}

Otake, Shiro ^{[1
]}

Fukushima, Takahiro ^{[1
]}

Kusumoto, Tatsuya ^{[1
]}

Morita, Atsuho ^{[1
]}

Azekawa, Shuhei ^{[1
]}

Watase, Mayuko ^{[1
]}

Asakura, Takanori ^{[1
,3
,4
]}

Masaki, Katsunori ^{[1
]}

Ishii, Makoto ^{[1
,5
]}

Endo, Akifumi ^{[6
]}

Koike, Ryuji ^{[6
]}

Ishikura, Hiroyasu ^{[7
]}

Takata, Tohru ^{[8
]}

Matsushita, Yasushi ^{[9
,10
]}

Harada, Norihiro ^{[11
,12
]}

Kokutou, Hiroyuki ^{[13
]}

Yoshiyama, Takashi ^{[13
]}

Kataoka, Kensuke ^{[14
]}

Mutoh, Yoshikazu ^{[15
]}

Miyawaki, Masayoshi ^{[16
]}

Ueda, Soichiro ^{[16
]}

Ono, Hiroshi ^{[17
]}

Ono, Takuya ^{[18
]}

Shoko, Tomohisa ^{[18
]}

Muranaka, Hiroyuki ^{[19
]}

Kawamura, Kodai ^{[19
]}

Mori, Nobuaki ^{[20
]}

Mochimaru, Takao ^{[21
]}

Fukui, Mototaka ^{[22
]}

Chihara, Yusuke ^{[22
]}

Nagasaki, Yoji ^{[23
]}

Okamoto, Masaki ^{[23
]}

Amishima, Masaru ^{[24
]}

Odani, Toshio ^{[25
]}

Tani, Mayuko ^{[26
]}

Nishi, Koichi ^{[26
]}

Shirai, Yuya ^{[27
]}

Edahiro, Ryuya ^{[27
]}

Ando, Akira ^{[5
]}

Hashimoto, Naozumi ^{[5
]}

Ogura, Shinji ^{[28
]}

Kitagawa, Yuichiro ^{[28
]}

Kita, Toshiyuki ^{[29
]}

Kagaya, Takashi ^{[29
]}

机构：

[1] Keio Univ, Dept Med, Div Pulm Med, Sch Med, 35 Shinanomachi,Shinjuku Ku, Tokyo 1608582, Japan

[2] Keio Univ, Dept Infect Dis, Sch Med, Tokyo, Japan

[3] Kitasato Univ, Sch Pharm, Lab Bioregulatory Med, Dept Clin Med, Tokyo, Japan

[4] Kitasato Univ, Kitasato Inst Hosp, Dept Resp Med, Tokyo, Japan

[5] Nagoya Univ, Dept Resp Med, Grad Sch Med, Nagoya, Aichi, Japan

[6] Tokyo Med & Dent Univ Hosp Med, Clin Res Ctr, Tokyo, Japan

[7] Fukuoka Univ Hosp, Fac Med, Dept Emergency & Crit Care Med, Fukuoka, Japan

[8] Fukuoka Univ, Dept Infect Control, Fukuoka, Japan

[9] Juntendo Univ, Fac Med, Dept Internal Med & Rheumatol, Tokyo, Japan

[10] Juntendo Univ, Grad Sch Med, Tokyo, Japan

[11] Juntendo Univ, Fac Med, Dept Resp Med, Tokyo, Japan

[12] Juntendo Univ, Grad Sch Med, Tokyo, Japan

[13] Fukujuji Hosp, Kiyose, Japan

[14] Tosei Gen Hosp, Dept Resp Med & Allergy, Seto, Japan

[15] Tosei Gen Hosp, Dept Infect Dis, Seto, Japan

[16] JCHO Japan Community Hlth Care Org, Dept Internal Med, Saitama Med Ctr, Saitama, Japan

[17] Kumamoto Med Ctr, Div Infect Dis & Resp Med, Kumamoto, Japan

[18] Tokyo Womens Med Univ, Adachi Med Ctr, Emergency & Crit Care Med, Tokyo, Japan

[19] Social Welf Org Saiseikai Imperial Gift Fdn Inc, Saiseikai Kumamoto Hosp, Div Resp Med, Kumamoto, Japan

[20] Natl Hosp Org Tokyo Med Ctr, Dept Gen Internal Med & Infect Dis, Tokyo, Japan

[21] Natl Hosp Org Tokyo Med Ctr, Dept Resp Med, Tokyo, Japan

[22] Uji Tokushukai Med Ctr, Uji, Japan

[23] Natl Hosp Org Kyushu Med Ctr, Dept Respirol, Fukuoka, Japan

[24] Natl Hosp Org Hokkaido Med Ctr, Dept Resp Med, Sapporo, Hokkaido, Japan

[25] Natl Hosp Org Hokkaido Med Ctr, Dept Rheumatol, Sapporo, Hokkaido, Japan

[26] Ishikawa Prefectural Cent Hosp, Kanazawa, Ishikawa, Japan

[27] Osaka Univ, Grad Sch Med, Dept Resp Med & Clin Immunol, Osaka, Japan

[28] Gifu Univ, Grad Sch Med, Dept Emergency & Disaster Med, Gifu, Japan

[29] Natl Hosp Org Kanazawa Med Ctr, Kanazawa, Ishikawa, Japan

[30] Saiseikai Yokohamashi Nanbu Hosp, Dept Resp Med, Yokohama, Kanagawa, Japan

[31] St Marianna Univ, Kawasaki Med Sch, Dept Internal Med, Div Gen Internal Med, Kawasaki, Kanagawa, Japan

[32] St Marianna Univ, Dept Emergency & Crit Care Med, Sch Med, Kawasaki, Kanagawa, Japan

[33] Tohoku Univ, Grad Sch Med, Dept Resp Med, Sendai, Miyagi, Japan

[34] Fukushima Med Univ, Sch Med, Dept Pulm Med, Fukushima, Japan

[35] Toyohashi Municipal Hosp, Dept Resp Med, Toyohashi, Aichi, Japan

[36] Natl Hosp Org Saitama Natl Hosp, Dept Gastroenterol, Wako, Saitama, Japan

[37] Osaka Saiseikai Nakatsu Hosp, Dept Resp Med, Osaka, Japan

[38] Saitama Cardiovasc & Resp Ctr, Dept Resp Med, Kumagaya, Saitama, Japan

[39] Showa Univ, Koto Toyosu Hosp, Div Allergol & Resp Med, Dept Med, Tokyo, Japan

[40] Kanagawa Cardiovasc & Resp Ctr, Dept Resp Med, Yokohama, Kanagawa, Japan

[41] Kansai Med Univ, Gen Med Ctr, Dept Emergency & Crit Care Med, Osaka, Japan

[42] Tokyo Med Univ Hosp, Dept Resp Med, Tokyo, Japan

[43] Tokyo Med Univ, Ibaraki Med Ctr, Inashiki, Ibaraki, Japan

[44] Ome Municipal Gen Hosp, Dept Resp Med, Tokyo, Japan

[45] Tsukuba Kinen Gen Hosp, Div Resp Med, Ibaraki, Japan

[46] Fujisawa City Hosp, Dept Resp Med, Fujisawa, Kanagawa, Japan

[47] Natl Def Med Coll, Dept Internal Med, Div Infect Dis & Resp Med, Saitama, Japan

[48] Kyoto Prefectural Univ Med, Dept Infect Control & Lab Med, Kyoto, Japan

[49] Kyoto Prefectural Univ Med, Dept Anesthesiol & Intens Care Med, Kyoto, Japan

[50] Osaka Univ, Grad Sch Med, Dept Stat Genet, Osaka, Japan

来源：

BMC PULMONARY MEDICINE | 2023年 / 23卷 / 01期

基金：

日本科学技术振兴机构; 日本学术振兴会;

关键词：

SARS-CoV-2; infection; Neutrophil-lymphocyte ratio; Mortality; Invasive mechanical ventilation; Intensive care unit; CLINICAL CHARACTERISTICS; INFLUENZA; COINFECTIONS; PNEUMONIA; SEVERITY; DISEASE;

D O I：

10.1186/s12890-023-02418-3

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

BackgroundAlthough cases of respiratory bacterial infections associated with coronavirus disease 2019 (COVID-19) have often been reported, their impact on the clinical course remains unclear. Herein, we evaluated and analyzed the complication rates of bacterial infections, causative organisms, patient backgrounds, and clinical outcome in Japanese patients with COVID-19.MethodsWe performed a retrospective cohort study that included inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021) and obtained demographic, epidemiological, and microbiological results and the clinical course and analyzed the cases of COVID-19 complicated by respiratory bacterial infections.ResultsOf the 1,863 patients with COVID-19 included in the analysis, 140 (7.5%) had respiratory bacterial infections. Community-acquired co-infection at COVID-19 diagnosis was uncommon (55/1,863, 3.0%) and was mainly caused by Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pneumoniae. Hospital-acquired bacterial secondary infections, mostly caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia, were diagnosed in 86 patients (4.6%). Severity-associated comorbidities were frequently observed in hospital-acquired secondary infection cases, including hypertension, diabetes, and chronic kidney disease. The study results suggest that the neutrophil-lymphocyte ratio (> 5.28) may be useful in diagnosing complications of respiratory bacterial infections. COVID-19 patients with community-acquired or hospital-acquired secondary infections had significantly increased mortality.ConclusionsRespiratory bacterial co-infections and secondary infections are uncommon in patients with COVID-19 but may worsen outcomes. Assessment of bacterial complications is important in hospitalized patients with COVID-19, and the study findings are meaningful for the appropriate use of antimicrobial agents and management strategies.

引用

页数：13

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