Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study.
Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study.
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DOI：
10.1093/ofid/ofaa578
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发表时间：
2021-01
影响因子：
4.2
通讯作者：
Fabre V
中科院分区：
文献类型：
--
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
细菌感染可使病毒性肺炎复杂化。最近的报告表明，在2019年冠状病毒病（COVID-19）中，出现细菌合并感染并不常见;然而，估计仅基于微生物学测试。我们寻求制定和应用共识定义，纳入临床标准，以更好地了解COVID-19的合并感染率和抗生素使用情况。评估了2020年3月1日至2020年5月31日期间在约翰霍普金斯卫生系统5家医院住院的1016名COVID-19成人患者。使用多学科团队为本研究制定的定义进行合并感染判定。评估了呼吸道和常见非呼吸道合并感染。细菌性社区获得性肺炎（bCAP）的定义包括已证实（临床、实验室和影像学标准加上微生物学诊断）、很可能（临床、实验室和影像学标准无微生物学诊断）和可能（并非所有临床、实验室和影像学标准均符合）类别。在共识定义的背景下评估临床特征和抗菌药物使用。细菌性呼吸道合并感染不常见（1.2%）; 1例患者确诊为bCAP，11例（1.1%）可能为bCAP。2例患者（0.2%）发生病毒性呼吸道合并感染。尽管69%的患者接受了抗生素治疗肺炎，但大多数可能或没有bCAP证据的患者在48小时内停止使用抗生素。最常见的非呼吸道感染是尿路感染（占队列的3%）。使用多学科共识定义，在因COVID-19住院的成人中，证实或可能的bCAP并不常见，其他非呼吸道细菌感染也是如此。经验性抗生素使用率很高，突出表明需要加强病毒性肺炎治疗中的抗生素管理。使用标准化的共识定义，我们评估了1，016名住院成人的COVID-19合并感染。疑似和可能的细菌性呼吸道合并感染率较低（1.2%），但大多数患者（69%）接受了抗生素治疗，这凸显了呼吸道病毒感染对抗生素管理的持续需求。
Bacterial infections may complicate viral pneumonias. Recent reports suggest that bacterial co-infection at time of presentation is uncommon in coronavirus disease 2019 (COVID-19); however, estimates were based on microbiology tests alone. We sought to develop and apply consensus definitions, incorporating clinical criteria to better understand the rate of co-infections and antibiotic use in COVID-19. A total of 1016 adult patients admitted to 5 hospitals in the Johns Hopkins Health System between March 1, 2020, and May 31, 2020, with COVID-19 were evaluated. Adjudication of co-infection using definitions developed by a multidisciplinary team for this study was performed. Both respiratory and common nonrespiratory co-infections were assessed. The definition of bacterial community-acquired pneumonia (bCAP) included proven (clinical, laboratory, and radiographic criteria plus microbiologic diagnosis), probable (clinical, laboratory, and radiographic criteria without microbiologic diagnosis), and possible (not all clinical, laboratory, and radiographic criteria met) categories. Clinical characteristics and antimicrobial use were assessed in the context of the consensus definitions. Bacterial respiratory co-infections were infrequent (1.2%); 1 patient had proven bCAP, and 11 (1.1%) had probable bCAP. Two patients (0.2%) had viral respiratory co-infections. Although 69% of patients received antibiotics for pneumonia, the majority were stopped within 48 hours in patients with possible or no evidence of bCAP. The most common nonrespiratory infection was urinary tract infection (present in 3% of the cohort). Using multidisciplinary consensus definitions, proven or probable bCAP was uncommon in adults hospitalized due to COVID-19, as were other nonrespiratory bacterial infections. Empiric antibiotic use was high, highlighting the need to enhance antibiotic stewardship in the treatment of viral pneumonias. Using standardized consensus definitions we evaluated 1,016 hospitalized adults for co-infections with COVID-19. Proven and probable bacterial respiratory co-infection was low (1.2%), yet most patients (69%) received antibiotics highlighting ongoing needs for antibiotic stewardship in respiratory viral infections.
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DOI：
10.1093/cid/ciy312
发表时间：
2018-10-30
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
McLaughlin JM;Jiang Q;Isturiz RE;Sings HL;Swerdlow DL;Gessner BD;Carrico RM;Peyrani P;Wiemken TL;Mattingly WA;Ramirez JA;Jodar L
通讯作者：
Jodar L
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：
17.1
作者：
Henry, Katharine E.;Hager, David N.;Saria, Suchi
通讯作者：
Saria, Suchi
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：
5.2
作者：
Beovic, Bojana;Dousak, May;Erdem, Hakan
通讯作者：
Erdem, Hakan