Risk factors associated with development of coinfection in critically Ill patients with COVID-19.
Risk factors associated with development of coinfection in critically Ill patients with COVID-19.
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DOI：
10.4266/acc.2022.00136
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发表时间：
2022-08
影响因子：
1.8
通讯作者：
Rajendram, Prabalini
中科院分区：
文献类型：
--
作者：
Orsini, Erica M.;Sacha, Gretchen L.;Han, Xiaozhen;Wang, Xiaofeng;Duggal, Abhijit;Rajendram, Prabalini
在2019冠状病毒病（COVID-19）大流行开始时，细菌和真菌合并感染对COVID-19患者的重要性尚不清楚。初步报告表明，一般人群中合并感染的流行率较低，但危重患者合并感染的风险尚不确定。这项观察性病例对照研究入组了900名患有COVID-19感染的重症成年患者。使用单变量和多变量分析比较合并感染患者（病例）和无合并感染患者（对照）。对合并感染的患者进行亚组分析，将其分为早期（7天内感染）和晚期（7天后感染）感染组。233例患者（25.9%）有细菌或真菌合并感染。血管加压药的使用（P<0.001）和疾病的严重程度（较高的急性生理学和慢性健康评估III评分，P=0.009）是发生合并感染的危险因素。合并感染的患者有较高的死亡率和住院时间。血管加压药和皮质类固醇的使用以及中心静脉导管和Foley导管的放置是晚期感染（>7天）的危险因素。耐药感染的发生率很高。重症COVID-19患者在因COVID-19住院期间面临社区获得性和医院获得性感染的风险。重要的是要考虑临床恶化的COVID-19重症患者合并感染的发展，并在选择经验性方案时考虑耐药性的可能性。
At outset of the coronavirus disease 2019 (COVID-19) pandemic, the significance of bacterial and fungal coinfections in individuals with COVID-19 was unknown. Initial reports indicated that the prevalence of coinfection in the general population was low, but there was uncertainty regarding the risk of coinfection in critically ill patients. Nine hundred critically ill adult patients with COVID-19 infection were enrolled in this observational case-control study. Patients with a coinfection (case) and patients without a coinfection (control) were compared using univariate and multivariable analyses. A subgroup analysis was performed on patients with coinfection, dividing them into early (infection within 7 days) and late (infection after 7 days) infection groups. Two hundred and thirty-three patients (25.9%) had a bacterial or fungal coinfection. Vasopressor use (P<0.001) and severity of illness (higher Acute Physiology and Chronic Health Evaluation III score, P=0.009) were risk factors for the development of a coinfection. Patients with coinfection had higher mortality and length of stay. Vasopressor and corticosteroid use and central line and foley catheter placement were risk factors for late infection (>7 days). There were high rates of drug-resistant infections. Critically ill patients with COVID-19 are at risk for both community-acquired and hospital-acquired infections throughout their hospitalization for COVID-19. It is important to consider the development of a coinfection in clinically worsening critically ill patients with COVID-19 and consider the likelihood of drug-resistance when choosing an empiric regimen.
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影响因子：
4.2
作者：
Karaba SM;Jones G;Helsel T;Smith LL;Avery R;Dzintars K;Salinas AB;Keller SC;Townsend JL;Klein E;Amoah J;Garibaldi BT;Cosgrove SE;Fabre V
通讯作者：
Fabre V
DOI：
10.1016/j.cmi.2020.07.041
发表时间：
2021-01
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Garcia-Vidal C;Sanjuan G;Moreno-García E;Puerta-Alcalde P;Garcia-Pouton N;Chumbita M;Fernandez-Pittol M;Pitart C;Inciarte A;Bodro M;Morata L;Ambrosioni J;Grafia I;Meira F;Macaya I;Cardozo C;Casals C;Tellez A;Castro P;Marco F;García F;Mensa J;Martínez JA;Soriano A;COVID-19 Researchers Group
通讯作者：
COVID-19 Researchers Group
DOI：
10.1016/j.cmi.2020.07.016
发表时间：
2020-12
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Langford BJ;So M;Raybardhan S;Leung V;Westwood D;MacFadden DR;Soucy JR;Daneman N
通讯作者：
Daneman N
影响因子：
14.2
作者：
Magiorakos, A. -P.;Srinivasan, A.;Monnet, D. L.
通讯作者：
Monnet, D. L.
影响因子：
5.8
作者：
Stekhoven, Daniel J.;Buehlmann, Peter
通讯作者：
Buehlmann, Peter