| Revista: | Revista do Instituto de Medicina Tropical de Sao Paulo |
| Base de datos: | |
| Número de sistema: | 000547821 |
| ISSN: | 0036-4665 |
| Autors: | Costa, Rafael Lessa da1 Lamas, Cristiane da Cruz2 Simvoulidis, Luiz Fernando Nogueira1 Espanha, Claudia Adelino1 Moreira, Lorena Pinto Monteiro1 Bonancim, Renan Alexandre Baptista1 Weber, João Victor Lehmkuhl Azeredo5 Ramos, Max Rogerio Freitas5 Silva, Eduardo Costa de Freitas5 Oliveira, Liszt Palmeira de5 |
| Institucions: | 1Hospital Unimed-Rio, Rio de Janeiro, Rio de Janeiro. Brasil 2Instituto Nacional de Cardiologia, Rio de Janeiro, Rio de Janeiro. Brasil 3Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Rio de Janeiro. Brasil 4Universidade Unigranrio, Rio de Janeiro, Rio de Janeiro. Brasil 5Instituto Unimed-Rio, Rio de Janeiro, Rio de Janeiro. Brasil |
| Any: | 2022 |
| Volum: | 64 |
| País: | Brasil |
| Idioma: | Inglés |
| Resumen en inglés | Some studies have shown that secondary infections during the COVID-19 pandemic may have contributed to the high mortality. Our objective was to identify the frequency, types and etiology of bacterial infections in patients with COVID-19 admitted to an intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and in-hospital mortality. It was a single-center study with a retrospective cohort of patients admitted consecutively to the ICU for more than 48 h between March and May 2020. Comparisons of groups with and without ICU- acquired infection were performed. A total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. The most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% of A. baumannii and in 57% of K. pneumoniae. The most prevalent infection was ventilator-associated pneumonia in 57.9% of patients with bacterial infections, or 17.3% of all COVID-19 patients admitted to the ICU, followed by tracheobronchitis (26.3%). Patients with secondary infections had a longer ICU stay (40.0 vs. 17 days; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0 days; p= 0.003). There were 68 (35.6%) deaths overall, of which 27 (39.7%) patients had bacterial infections. Among the 123 survivors, 30 (24.4%) had a secondary infections (OR 2.041; 95% CI 1.080 - 3.859). A high incidence of secondary infections, mainly caused by gram-negative bacteria has been observed. Secondary infections were associated with longer ICU stay, MV use and higher mortality. |
| Keyword: | COVID-19, Secondary infections, Healthcare associated infection, Intensive care unit, Gram negatives, Multidrug-resistance, Ventilator-associated pneumonia |
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