Co-infection in critically ill patients with COVID-19: an observational cohort study from England.
Co-infection in critically ill patients with COVID-19: an observational cohort study from England.
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DOI：
10.1099/jmm.0.001350
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发表时间：
2021-04
影响因子：
3
通讯作者：
Lim WS
中科院分区：
文献类型：
--
作者：
Baskaran V;Lawrence H;Lansbury LE;Webb K;Safavi S;Zainuddin NI;Huq T;Eggleston C;Ellis J;Thakker C;Charles B;Boyd S;Williams T;Phillips C;Redmore E;Platt S;Hamilton E;Barr A;Venyo L;Wilson P;Bewick T;Daniel P;Dark P;Jeans AR;McCanny J;Edgeworth JD;Llewelyn MJ;Schmid ML;McKeever TM;Beed M;Lim WS
在以前的病毒大流行期间，报告的合并感染率和涉及的病原体各不相同。在1918年流感大流行中，很大一部分严重疾病和死亡是由细菌合并感染引起的，主要是肺炎链球菌和金黄色葡萄球菌。更好地了解COVID-19感染患者合并感染的发生率以及所涉及的病原体对于有效的抗菌管理是必要的。描述英格兰重症成人COVID-19感染合并感染的发生率和性质。对截至2020年5月18日在英格兰入住七个重症监护病房（ICU）的成年COVID-19患者进行了一项回顾性队列研究。纳入了完成ICU住院的患者。在入院后48小时确定微生物的比例和类型<48 and >，对应于社区和医院获得性合并感染。在研究的254例患者中（中位年龄59岁（IQR 49-69）; 64.6%为男性），从83例（32.7%）患者中鉴定出139种具有临床意义的微生物。 14例（5.5%）患者在入院后48小时内发现细菌合并感染/合并定植;最常见的病原体是金黄色葡萄球菌（4例患者）和肺炎链球菌（2例患者）。 病原体检出率随ICU停留时间的增加而增加，主要由革兰氏阴性菌组成，尤其是肺炎克雷伯菌和大肠埃希菌。入院后>48小时的合并感染/合并定植率为27/1000人-天（95% CI 21.3-34.1）。 与未合并感染/合并定植的患者相比，合并感染/合并定植的患者更可能在ICU中死亡（粗OR 1.78，95%CI 1.03-3.08，P=0.04）。我们发现，在患有COVID-19的住院成人中，社区获得性细菌合并感染的证据有限，但在ICU住院期间获得的革兰氏阴性菌感染率很高。
During previous viral pandemics, reported co-infection rates and implicated pathogens have varied. In the 1918 influenza pandemic, a large proportion of severe illness and death was complicated by bacterial co-infection, predominantly Streptococcus pneumoniae and Staphylococcus aureus . A better understanding of the incidence of co-infection in patients with COVID-19 infection and the pathogens involved is necessary for effective antimicrobial stewardship. To describe the incidence and nature of co-infection in critically ill adults with COVID-19 infection in England. A retrospective cohort study of adults with COVID-19 admitted to seven intensive care units (ICUs) in England up to 18 May 2020, was performed. Patients with completed ICU stays were included. The proportion and type of organisms were determined at <48 and >48 h following hospital admission, corresponding to community and hospital-acquired co-infections. Of 254 patients studied (median age 59 years (IQR 49–69); 64.6 % male), 139 clinically significant organisms were identified from 83 (32.7 %) patients. Bacterial co-infections/ co-colonisation were identified within 48 h of admission in 14 (5.5 %) patients; the commonest pathogens were Staphylococcus aureus (four patients) and Streptococcus pneumoniae (two patients). The proportion of pathogens detected increased with duration of ICU stay, consisting largely of Gram-negative bacteria, particularly Klebsiella pneumoniae and Escherichia coli . The co-infection/ co-colonisation rate >48 h after admission was 27/1000 person-days (95 % CI 21.3–34.1). Patients with co-infections/ co-colonisation were more likely to die in ICU (crude OR 1.78,95 % CI 1.03–3.08, P=0.04) compared to those without co-infections/ co-colonisation. We found limited evidence for community-acquired bacterial co-infection in hospitalised adults with COVID-19, but a high rate of Gram-negative infection acquired during ICU stay.
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影响因子：
8.1
作者：
Contou, Damien;Claudinon, Aurore;Plantefeve, Gaetan
通讯作者：
Plantefeve, Gaetan
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
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
影响因子：
8.8
作者：
Arabi, Yaseen M.;Al-Omari, Awad;Balkhy, Hanan H.
通讯作者：
Balkhy, Hanan H.
影响因子：
1.2
作者：
Gajdacs, Mario;Doczi, Ilona;Burian, Katalin
通讯作者：
Burian, Katalin