Pinki J Bhatt1,2, Stephanie Shiau3, Luigi Brunetti2, Yingda Xie4, Kinjal Solanki1, Shaza Khalid4, Sana Mohayya5, Pak Ho Au6, Christopher Pham7, Priyanka Uprety8, Ronald Nahass9, Navaneeth Narayanan1,2. 1. Division of Allergy/Immunology and Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. 2. Department of Pharmacy Practice and Administration, Rutgers University Ernest Mario School of Pharmacy, Piscataway, New Jersey, USA. 3. Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA. 4. Division of Infectious Diseases, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA. 5. Department of Pharmacy, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA. 6. Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. 7. Rutgers New Jersey Medical School, Newark, New Jersey, USA. 8. Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. 9. ID Care, Hillsborough, New Jersey, USA.
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic. Clinical characteristics regarding secondary infections in patients with COVID-19 have been reported, but detailed microbiology, risk factors, and outcomes of secondary bloodstream infections (sBSIs) in patients with severe COVID-19 have not been well described. METHODS: We performed a multicenter case-control study including all hospitalized patients diagnosed with severe COVID-19 and blood cultures drawn from 1 March 2020 to 7 May 2020 at 3 academic medical centers in New Jersey. Data collection included demographics, clinical and microbiologic variables, and patient outcomes. Risk factors and outcomes were compared between cases (sBSI) and controls (no sBSI). RESULTS: A total of 375 hospitalized patients were included. There were 128 sBSIs during the hospitalization. For the first set of positive blood cultures, 117 (91.4%) were bacterial and 7 (5.5%) were fungal. Those with sBSI were more likely to have altered mental status, lower mean percentage oxygen saturation on room air, have septic shock, and be admitted to the intensive care unit compared with controls. In-hospital mortality was higher in those with an sBSI versus controls (53.1% vs 32.8%, P = .0001). CONCLUSIONS: We observed that hospitalized adult patients with severe COVID-19 and sBSI had a more severe initial presentation, prolonged hospital course, and worse clinical outcomes. To maintain antimicrobial stewardship principles, further prospective studies are necessary to better characterize risk factors and prediction modeling to better understand when to suspect and empirically treat for sBSIs in severe COVID-19.
BACKGROUND:Coronavirus disease 2019 (COVID-19) has become a global pandemic. Clinical characteristics regarding secondary infections in patients with COVID-19 have been reported, but detailed microbiology, risk factors, and outcomes of secondary bloodstream infections (sBSIs) in patients with severe COVID-19 have not been well described. METHODS: We performed a multicenter case-control study including all hospitalized patients diagnosed with severe COVID-19 and blood cultures drawn from 1 March 2020 to 7 May 2020 at 3 academic medical centers in New Jersey. Data collection included demographics, clinical and microbiologic variables, and patient outcomes. Risk factors and outcomes were compared between cases (sBSI) and controls (no sBSI). RESULTS: A total of 375 hospitalized patients were included. There were 128 sBSIs during the hospitalization. For the first set of positive blood cultures, 117 (91.4%) were bacterial and 7 (5.5%) were fungal. Those with sBSI were more likely to have altered mental status, lower mean percentage oxygen saturation on room air, have septic shock, and be admitted to the intensive care unit compared with controls. In-hospital mortality was higher in those with an sBSI versus controls (53.1% vs 32.8%, P = .0001). CONCLUSIONS: We observed that hospitalized adult patients with severe COVID-19 and sBSI had a more severe initial presentation, prolonged hospital course, and worse clinical outcomes. To maintain antimicrobial stewardship principles, further prospective studies are necessary to better characterize risk factors and prediction modeling to better understand when to suspect and empirically treat for sBSIs in severe COVID-19.
Authors: Roberto Lozano-Rodríguez; Verónica Terrón-Arcos; Raúl López; Juan Martín-Gutiérrez; Alejandro Martín-Quirós; Charbel Maroun-Eid; Elena Muñoz Del Val; Carlos Cañada-Illana; Alejandro Pascual Iglesias; Jaime Valentín Quiroga; Karla Montalbán-Hernández; José Carlos Casalvilla-Dueñas; Miguel A García-Garrido; Álvaro Del Balzo-Castillo; María A Peinado-Quesada; Laura Gómez-Lage; Carmen Herrero-Benito; Ray G Butler; José Avendaño-Ortiz; Eduardo López-Collazo Journal: J Clin Med Date: 2022-06-08 Impact factor: 4.964
Authors: Yanan Zhao; Marcus H Cunningham; Jose R Mediavilla; Steven Park; Sean Fitzgerald; Hee Sang Ahn; Xiangyang Li; Caixin Zhan; Tao Hong; Gary Munk; Kar Fai Chow; David S Perlin Journal: Sci Rep Date: 2021-02-23 Impact factor: 4.379
Authors: Akshay Khatri; Prashant Malhotra; Stephanie Izard; Angela Kim; Michael Oppenheim; Pranisha Gautam-Goyal; Thomas Chen; Thien-Ly Doan; Ilan Berlinrut; Negin Niknam; Sarah Flannery; David Hirschwerk; Marcia Epstein; Bruce Farber Journal: Open Forum Infect Dis Date: 2021-06-30 Impact factor: 3.835