COVID-19 association with multidrug-resistant bacteria superinfections: Lessons for future challenges

Susan,Monica; Susan,Razvan; Lazar,Viorica; Bagiu,Iulia-Cristina; Mihu,Alin Gabriel; Bagiu,Radu Vasile; Ionescu,Alin; Iana,Andreea Narcisa; Dehelean,Cristina Adriana; Lighezan,Daniel; Marti,Daniela Teodora

doi:10.3892/etm.2023.11953

COVID-19 association with multidrug-resistant bacteria superinfections: Lessons for future challenges

Authors:
- Monica Susan
- Razvan Susan
- Viorica Lazar
- Iulia-Cristina Bagiu
- Alin Gabriel Mihu
- Radu Vasile Bagiu
- Alin Ionescu
- Andreea Narcisa Iana
- Cristina Adriana Dehelean
- Daniel Lighezan
- Daniela Teodora Marti
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Affiliations: Department of Internal Medicine, Centre for Preventive Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania, Department of Family Medicine, Centre for Preventive Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania, Department of General Medicine, Vasile Goldis University of Medicine, Arad 310048, Romania, Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania, Bioclinica Medical Analysis Laboratory, Arad 310300, Romania, Department of Hygiene, Preventive Medicine Study Center, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania, Department of Toxicology, Research Center for Pharmaco‑Toxicological Evaluations, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania, Department of Internal Medicine, Advanced Research Center for Cardiovascular Pathology and Haemostaseology, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania, Department of Biology and Life Sciences, Vasile Goldis University of Medicine, Arad 310048, Romania
Published online on: April 18, 2023 https://doi.org/10.3892/etm.2023.11953
Article Number: 254
Copyright: © Susan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The future waves of COVID 19 infections will continue to raise serious problems in patients with severe forms of the disease. Bacterial infections associated with SARS‑CoV‑2 disease may complicate the progress of hospitalized patients with COVID‑19. The present study aimed to evaluate the etiological spectrum of superinfection in adult patients with COVID‑19 and to investigate the correlation between superinfection with multidrug‑resistant (MDR) bacteria and serum procalcitonin (PCT). A total of 82 COVID‑19 hospitalized patients with COVID‑19 and bacterial superinfection were included. The superinfections were classified into early infections (3‑7 days from admission) and late infections (>7 days from admission). Bacterial superinfection etiological spectrum, MDR bacteria profile and levels of serum PCT were studied. The most frequently isolated bacteria were Klebsiella pneumoniae, Acinetobacter baumannii and Enterococcus spp. MDR bacteria were involved in 73.17% of COVID‑19 patients with bacterial superinfections. Most MDR bacteria superinfections (73.52%) occurred in the late infection period. Klebsiella pneumoniae, Enterococcus spp. and Methicillin‑resistant Staphylococcus aureus were the most common MDR bacteria identified in late infections after hospitalization in 20.43, 4.30 and 4.30% of all infections, respectively. Serum PCT values were significantly higher in patients with MDR bacteria superinfection compared with patients with sensitive bacteria superinfection (P=0.009). The principal findings of the present study were the high prevalence of superinfection with MDR bacteria among the COVID‑19 patients with bacterial superinfections and the presence of a statistically significant association between serum PCT levels and the presence of superinfection with MDR bacteria. The most effective way to fight against microbial resistance to antibiotics, whether it occurs independently or overlaps with viral infections, is to pursue a national policy for the rational use of antibiotics.

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