.: ORİJİNAL ARAŞTIRMA
Evaluation of Secondary Infections in COVID-19 PatientsHospitalized in Intensive Care Unit:Retrospective Observational Study
Yoğun Bakımda Ünitesinde Yatan COVID-19 TanılıHastalardaki Sekonder Enfeksiyonların Değerlendirilmesi:Retrospektif Gözlemsel Çalışma
Turkiye Klinikleri J Med Sci. 2022;42(3):164-70
doi: 10.5336/medsci.2021-87367
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Patients infected with severe acute respiratory syndrome-coronavirus-2 may progress with severe clinical symptoms and patients may be hospitalized in intensive care for a long time. In patients with long-term intensive care hospitalization, secondary infections develop as a result of the pathophysiology of the disease and the treatments used. The aim of this study is to investigate the incidence of secondary infections in patients with coronavirus disease-2019 (COVID-19) and to identify common pathogen groups. Material and Methods: Four hundred and sixty one patients with a diagnosis of COVID-19 who were followed up in the intensive care unit at Afyonkarahisar Health Sciences University Faculty of Medicine Hospital between 20 March 2020 and 31 May 2021 were included in the study. Demographic data, co-morbidities, clinical features, laboratory data and culture growth data of the patients were recorded retrospectively. Results: Nosocomial secondary infections were detected in 132 (28.6%) of 461 patients. Acinetobacter baumannii 39/53 (73.5%) growth was observed in the majority of the lower respiratory tract sample cultures. There was 28/49 (57.1%) Staphylococcus aureus growth in blood cultures, and 21/42 (50%) candida spp. growth in urine cultures. Conclusion: In this study, we found that the incidence of infection secondary to COVID-19 pneumonia was high. In addition, it was determined that the secondary infection rate was high in patients with PaO2/FiO2<200.
Keywords: Acinetobacter baumannii; bacterial infections; COVID-19; nosocomial infections; secondary infections
Objective: Patients infected with severe acute respiratory syndrome-coronavirus-2 may progress with severe clinical symptoms and patients may be hospitalized in intensive care for a long time. In patients with long-term intensive care hospitalization, secondary infections develop as a result of the pathophysiology of the disease and the treatments used. The aim of this study is to investigate the incidence of secondary infections in patients with coronavirus disease-2019 (COVID-19) and to identify common pathogen groups. Material and Methods: Four hundred and sixty one patients with a diagnosis of COVID-19 who were followed up in the intensive care unit at Afyonkarahisar Health Sciences University Faculty of Medicine Hospital between 20 March 2020 and 31 May 2021 were included in the study. Demographic data, co-morbidities, clinical features, laboratory data and culture growth data of the patients were recorded retrospectively. Results: Nosocomial secondary infections were detected in 132 (28.6%) of 461 patients. Acinetobacter baumannii 39/53 (73.5%) growth was observed in the majority of the lower respiratory tract sample cultures. There was 28/49 (57.1%) Staphylococcus aureus growth in blood cultures, and 21/42 (50%) candida spp. growth in urine cultures. Conclusion: In this study, we found that the incidence of infection secondary to COVID-19 pneumonia was high. In addition, it was determined that the secondary infection rate was high in patients with PaO2/FiO2<200.
Keywords: Acinetobacter baumannii; bacterial infections; COVID-19; nosocomial infections; secondary infections
ÖZET
Amaç: Şiddetli akut solunum sendromu-koronavirüs-2 ile enfekte olan hastalar ciddi klinik semptomlarla seyredebilir ve uzun süre yoğun bakımda kalabilir. Uzun süreli yoğun bakımda kalışlarla birlikte hastalığın patofizyolojisi ve kullanılan tedaviler sonucunda sekonder enfeksiyonlar gelişmektedir. Bu çalışmanın amacı, koronavirüs hastalığı- 2019 [coronavirus disease-2019 (COVID-19)] olan hastalarda ikincil enfeksiyonların insidansını araştırmak ve yaygın patojen gruplarını tanımlamaktır. Gereç ve Yöntemler: Afyonkarahisar Sağlık Bilimler Üniversitesi Tıp Fakültesi Hastanesinde 20 Mart 2020-31 Mayıs 2021 tarihleri arasında COVID-19 yoğun bakım ünitesinde takip edilen 461 COVID-19 tanılı hasta çalışmaya dâhil edildi. Retrospektif olarak hastaların demografik verileri, komorbiditeleri, klinik özellikleri, laboratuvar verileri ve kültür üreme verileri kaydedildi. Bulgular: Toplam 461 hastanın 132'sinde (%28,6) de nozokomiyal sekonder enfeksiyon tespit edildi. Alt solunum yolu örnek kültürünün çoğunluğunda Acinetobacter baumannii 39/53 (%73,5) üremesi olurken, kan kültürlerinde 28/49 (%57,1) Staphylococcus aureus üremesi, idrar kültüründe ise 21/42 (%50) candida spp. üremesi oldu. Sonuç: Bu çalışmada, COVID-19 pnömonisine sekonder gelişen enfeksiyon gelişme insidansının yüksek olduğunu bulduk. PaO2/FiO2<200 olan hastalarda sekonder enfeksiyonların yüksek olduğunu tespit ettik.
Anahtar Kelimeler: Acinetobacter baumannii; bakteriyel enfeksiyonlar; COVID-19; nozokomiyal enfeksiyon; sekonder enfeksiyonlar
Amaç: Şiddetli akut solunum sendromu-koronavirüs-2 ile enfekte olan hastalar ciddi klinik semptomlarla seyredebilir ve uzun süre yoğun bakımda kalabilir. Uzun süreli yoğun bakımda kalışlarla birlikte hastalığın patofizyolojisi ve kullanılan tedaviler sonucunda sekonder enfeksiyonlar gelişmektedir. Bu çalışmanın amacı, koronavirüs hastalığı- 2019 [coronavirus disease-2019 (COVID-19)] olan hastalarda ikincil enfeksiyonların insidansını araştırmak ve yaygın patojen gruplarını tanımlamaktır. Gereç ve Yöntemler: Afyonkarahisar Sağlık Bilimler Üniversitesi Tıp Fakültesi Hastanesinde 20 Mart 2020-31 Mayıs 2021 tarihleri arasında COVID-19 yoğun bakım ünitesinde takip edilen 461 COVID-19 tanılı hasta çalışmaya dâhil edildi. Retrospektif olarak hastaların demografik verileri, komorbiditeleri, klinik özellikleri, laboratuvar verileri ve kültür üreme verileri kaydedildi. Bulgular: Toplam 461 hastanın 132'sinde (%28,6) de nozokomiyal sekonder enfeksiyon tespit edildi. Alt solunum yolu örnek kültürünün çoğunluğunda Acinetobacter baumannii 39/53 (%73,5) üremesi olurken, kan kültürlerinde 28/49 (%57,1) Staphylococcus aureus üremesi, idrar kültüründe ise 21/42 (%50) candida spp. üremesi oldu. Sonuç: Bu çalışmada, COVID-19 pnömonisine sekonder gelişen enfeksiyon gelişme insidansının yüksek olduğunu bulduk. PaO2/FiO2<200 olan hastalarda sekonder enfeksiyonların yüksek olduğunu tespit ettik.
Anahtar Kelimeler: Acinetobacter baumannii; bakteriyel enfeksiyonlar; COVID-19; nozokomiyal enfeksiyon; sekonder enfeksiyonlar
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