COVID-19 associated bacterial infections in intensive care unit: a case control study

We described the secondary bacterial infections (SBI) among COVID-19 patients in comparison with non-COVID-19 patients. We performed a retrospective case-control study between January 01, 2020 and April 01, 2022. Including the adult patients, who stayed & GE; 72 h in intensive care unit (ICU). In total 405 patients were included, 135 had (33.3%) COVID-19, with similar age and gender. The length of stay in ICU was not different (11.4 vs 8.2, p = 0.109), however mean intubation days were higher among COVID-19 cases (6.5 vs 3.8, p = 0.005), SBI were more common among COVID-19 cases (34% vs 10.7%, p < 0.001). Among the patients with pneumonia, the rate of gram-positive bacteria was higher in COVID-19 group than the control group (39% vs 5%, p = 0.006). The predictors for SBI were having COVID-19 (OR: 2.3, Cl 1.25-4.32, p = 0.008), days of intubation (OR: 1.05, Cl 1.01-1.10, p = 0.004), and being male (OR: 2, Cl 1.12-3.58, p = 0.018). The predictors of mortality were COVID-19 (OR: 2.38, Cl 1.28-4.42, p = 0.006), days of intubation (OR: 1.06, Cl 1.03-1.09, p < 0.001), active hematologic malignancy (OR: 3.1, Cl: 1.33-7.28, p = 0.09), active solid tumors (OR: 2.44, Cl 1.21-4.91, p = 0.012), and coronary artery diseases (OR: 1.8, Cl 1.01-3.52, p = 0.045). The most common SBI in COVID-19 patients were methicillin-sensitive Staphylococcus aureus. No carbapenem-resistant Enterobacterales related infections were detected in COVID-19 patients.

Automated summary

We compared secondary bacterial infections (SBI) between COVID-19 patients and non-COVID-19 patients. A retrospective case-control study was conducted from January 01, 2020 to April 01, 2022, including adult patients who stayed in the intensive care unit (ICU) for 72 hours or longer. The study included a total of 405 patients, with 135 (33.3%) being COVID-19 patients, who had similar age and gender. COVID-19 patients had a higher rate of SBI, especially in cases of pneumonia, with gram-positive bacteria being more common in the COVID-19 group. Predictors of SBI included having COVID-19, intubation days, and being male. COVID-19, intubation days, active hematologic malignancy, active solid tumors, and coronary artery diseases were predictors of mortality. Methicillin-sensitive Staphylococcus aureus was the most common SBI in COVID-19 patients, while carbapenem-resistant Enterobacterales infections were not detected.