Diagnostic significance of secondary bacteremia in patients with COVID-19.
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Nakagawara Kensuke, Kamata Hirofumi, Chubachi Shotaro, Namkoong Ho, Tanaka Hiromu, Lee Ho, Otake Shiro, Fukushima Takahiro, Kusumoto Tatsuya, Morita Atsuho, Azekawa Shuhei, Watase Mayuko, Asakura Takanori, Masaki Katsunori, Ishii Makoto, Endo Akifumi, Koike Ryuji, Ishikura Hiroyasu, Takata Tohru, Matsushita Yasushi, Harada Norihiro, Kokutou Hiroyuki, Yoshiyama Takashi, Kataoka Kensuke, Mutoh Yoshikazu, Miyawaki Masayoshi, Ueda Soichiro, Ono Hiroshi, Ono Takuya, Shoko Tomohisa, Muranaka Hiroyuki, Kawamura Kodai, Mori Nobuaki, Mochimaru Takao, Fukui Mototaka, Chihara Yusuke, Nagasaki Yoji, Okamoto Masaki, Amishima Masaru, Odani Toshio, Tani Mayuko, Nishi Koichi, Shirai Yuya, Edahiro Ryuya, Ando Akira, Hashimoto Naozumi, Ogura Shinji, Kitagawa Yuichiro, Kita Toshiyuki, Kagaya Takashi, Kimura Yasuhiro, Miyazawa Naoki, Tsuchida Tomoya, Fujitani Shigeki, Murakami Koji, Sano Hirohito, Sato Yuki, Tanino Yoshinori, Otsuki Ryo, Mashimo Shuko, Kuramochi Mizuki, Hosoda Yasuo, Hasegawa Yoshinori, Ueda Tetsuya, Takaku Yotaro, Ishiguro Takashi, Fujiwara Akiko, Kuwahara Naota, Kitamura Hideya, Hagiwara Eri, Nakamori Yasushi, Saito Fukuki, Kono Yuta, Abe Shinji, Ishii Tomoo, Ohba Takehiko, Kusaka Yu, Watanabe Hiroko, Masuda Makoto, Watanabe Hiroki, Kimizuka Yoshifumi, Kawana Akihiko, Kasamatsu Yu, Hashimoto Satoru, Okada Yukinori, Takano Tomomi, Katayama Kazuhiko, Ai Masumi, Kumanogoh Atsushi, Sato Toshiro, Tokunaga Katsushi, Imoto Seiya, Kitagawa Yuko, Kimura Akinori, Miyano Satoru, Hasegawa Naoki, Ogawa Seishi, Kanai Takanori, Fukunaga Koichi, Japan COVID-19 Task Force
Аннотация
METHODS: This was a retrospective cohort study that included data from inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021). We obtained demographic, epidemiological, and microbiological data throughout the course of hospitalization and analyzed the cases of COVID-19 complicated by non-respiratory bacterial infections.
RESULTS: Of the 1914 patients included, non-respiratory bacterial infections with COVID-19 were diagnosed in 81 patients (4.2%). Of these, 59 (3.1%) were secondary infections. Bacteremia was the most frequent bacterial infection, occurring in 33 cases (55.9%), followed by urinary tract infections in 16 cases (27.1%). Staphylococcus epidermidis was the most common causative organism of bacteremia. Patients with COVID-19 with non-respiratory secondary bacterial infections had significantly higher mortality, and a multivariate logistic regression analysis demonstrated that those with bacteremia (aOdds Ratio = 15.3 [5.97-39.1]) were at higher risk of death. Multivariate logistic regression analysis showed that age, male sex, use of steroids to treat COVID-19, and intensive care unit admission increased the risk for nosocomial bacteremia.
CONCLUSIONS: Secondary bacteremia is an important complication that may lead to poor prognosis in cases with COVID-19. An appropriate medical management strategy must be established, especially for patients with concomitant predisposing factors.