Incidence of Concomitant Bacterial Infection in Hospitalized Patients Admitted Through the Emergency Department with A Positive Viral Respiratory Panel.

BACKGROUND

There has been limited research on the prevalence of concomitant bacterial infections in Emergency Department (ED) patients with a positive viral test.

OBJECTIVE

To determine the frequency and characteristics of adult patients admitted to the hospital from the ED with a positive viral isolate(s) who were also determined to have a concomitant bacterial infection on admission.

METHODS

A retrospective study was conducted for three EDs in a Midwestern health system for the period of July 2022 through June 2023. Included in the study were adult inpatients admitted through the ED with a positive viral isolate. Variables of interest included labora values, clinical information, and antibiotic therapy data.

RESULTS

The study included 892 patients, with 682 (76%) categorized as viral only infection (ViO) and 210 (24%) as viral plus concomitant bacterial infection (ViCon). Twenty-one percent (45/210) of ViCon patients were categorized as bacteremic. Seventy-two percent (119/165) of nonbacteremic patients and 44% (20/45) of bacteremic patients had a bacterial respiratory source. In patients receiving antibiotics (n = 558), ViCon patients received a median of 3 (95% CI: 2, 4) more days of therapy than ViO patients. A standard deviation increase in bandemia and procalcitonin were associated with a 1.5 (95% CI: 1.3, 1.9) and 1.6 (95% CI: 1.2, 2.3) times higher adjusted odds ratio of being in the ViCon group, respectively.

CONCLUSION

A quarter of ED admitted patients with a positive viral isolate had a concomitant bacterial infection. ViCon patients received more days of antibiotic therapy and had higher bandemia and procalcitonin values.