Bacterial Superinfections Among Persons With Coronavirus Disease 2019: A Comprehensive Review of Data From Postmortem Studies.
Bacterial Superinfections Among Persons With Coronavirus Disease 2019: A Comprehensive Review of Data From Postmortem Studies.
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DOI：
10.1093/ofid/ofab065
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发表时间：
2021-03
影响因子：
4.2
通讯作者：
Nguyen MH
中科院分区：
文献类型：
--
作者：
Clancy CJ;Schwartz IS;Kula B;Nguyen MH
有限的临床数据表明，2019年冠状病毒病（COVID-19）重症患者中细菌重复感染的患病率约为16%。我们回顾了截至2020年9月26日以英文发表的COVID-19患者的尸检研究，以获得与细菌性肺部感染一致的组织病理学结果。在全球范围内，纳入了来自75项研究的621例患者。数据质量参差不齐，可能是因为在96%（72/75）的研究中，确定重复感染不是主要目标。32%（200/621）的患者（22-96岁; 66%为男性）报告了与潜在肺部二重感染一致的组织学。感染类型为肺炎（95%）、脓胸或脓胸（3.5%）和脓毒性栓塞（1.5%）。73%的肺炎是局灶性的，而不是弥漫性的。主要的组织病理学发现是肺泡内嗜酸性细胞浸润，与COVID-19相关的弥漫性肺泡损伤的典型表现不同。在有可用数据的研究中，79%的患者接受了抗菌治疗;最常见的药物是β-内酰胺/β-内酰胺酶抑制剂（48%）、大环内酯类（16%）、头孢菌素类（12%）和碳青霉烯类（6%）。在尸检研究中，25.5%（51/200）的潜在病例和8%的所有患者通过直接观察或回收细菌来证明重复感染。按等级顺序，病原体包括鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌。肺部重复感染是16%的潜在病例和3%的COVID-19患者的死亡原因。在32%死于COVID-19的人的尸检中，潜在的细菌性肺部双重感染是明显的（证实，8%;可能，24%），但它们是罕见的死亡原因。在已发表的尸检研究中，32%的COVID-19患者的肺组织病理学与潜在的细菌双重感染一致（已证实，8%;可能，24%）。肺部细菌二重感染仅占COVID-19患者死亡人数的3%。
Limited clinical data suggest a ~16% prevalence of bacterial superinfections among critically ill patients with coronavirus disease 2019 (COVID-19). We reviewed postmortem studies of patients with COVID-19 published in English through September 26, 2020, for histopathologic findings consistent with bacterial lung infections. Worldwide, 621 patients from 75 studies were included. The quality of data was uneven, likely because identifying superinfections was not a major objective in 96% (72/75) of studies. Histopathology consistent with a potential lung superinfection was reported in 32% (200/621) of patients (22–96 years old; 66% men). Types of infections were pneumonia (95%), abscesses or empyema (3.5%), and septic emboli (1.5%). Seventy-three percent of pneumonias were focal rather than diffuse. The predominant histopathologic findings were intra-alveolar neutrophilic infiltrations that were distinct from those typical of COVID-19-associated diffuse alveolar damage. In studies with available data, 79% of patients received antimicrobial treatment; the most common agents were beta-lactam/beta-lactamase inhibitors (48%), macrolides (16%), cephalosoprins (12%), and carbapenems (6%). Superinfections were proven by direct visualization or recovery of bacteria in 25.5% (51/200) of potential cases and 8% of all patients in postmortem studies. In rank order, pathogens included Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Lung superinfections were the cause of death in 16% of potential cases and 3% of all patients with COVID-19. Potential bacterial lung superinfections were evident at postmortem examination in 32% of persons who died with COVID-19 (proven, 8%; possible, 24%), but they were uncommonly the cause of death. In published postmortem studies, 32% of patients with COVID-19 had lung histopathology consistent with potential bacterial superinfections (proven, 8%; possible, 24%). Bacterial superinfections of the lungs were responsible for only 3% of deaths among COVID-19 patients.
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DOI：
10.1016/j.prp.2020.153228
发表时间：
2020-10
期刊：
Pathology, research and practice
影响因子：
--
作者：
Sadegh Beigee F;Pourabdollah Toutkaboni M;Khalili N;Nadji SA;Dorudinia A;Rezaei M;Askari E;Farzanegan B;Marjani M;Rafiezadeh A
通讯作者：
Rafiezadeh A
影响因子：
3.5
作者：
Boesmueller, Hans;Traxler, Selina;Fend, Falko
通讯作者：
Fend, Falko
影响因子：
2.4
作者：
Brook, Olga R.;Piper, Kimberly G.;Hecht, Jonathan L.
通讯作者：
Hecht, Jonathan L.
DOI：
10.1016/j.patol.2020.05.004
发表时间：
2020-07-01
期刊：
Revista espanola de patologia : publicacion oficial de la Sociedad Espanola de Anatomia Patologica y de la Sociedad Espanola de Citologia
影响因子：
--
作者：
通讯作者：
--
影响因子：
1.2
作者：
Beigmohammadi MT;Jahanbin B;Safaei M;Amoozadeh L;Khoshavi M;Mehrtash V;Jafarzadeh B;Abdollahi A
通讯作者：
Abdollahi A