Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit
Background. Multidrug-resistant Acinetobacter (MDR-Ab) is one of the most important pathogens causing superinfections in COVID-19 patients hospitalised in the intensive care unit (ICU). The occurrence of MDR-Ab superinfection significantly impairs the prognosis of patients in the ICU. Overuse of ant...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2023/4951273 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832559608896421888 |
|---|---|
| author | P. Mihalov J. Hodosy A. Koščálová M. Čaprnda M. Kachlíková J. Jurenka M. Bendžala P. Sabaka |
| author_facet | P. Mihalov J. Hodosy A. Koščálová M. Čaprnda M. Kachlíková J. Jurenka M. Bendžala P. Sabaka |
| author_sort | P. Mihalov |
| collection | DOAJ |
| description | Background. Multidrug-resistant Acinetobacter (MDR-Ab) is one of the most important pathogens causing superinfections in COVID-19 patients hospitalised in the intensive care unit (ICU). The occurrence of MDR-Ab superinfection significantly impairs the prognosis of patients in the ICU. Overuse of antibiotics in COVID-19 patients might contribute to the risk of developing MDR-Ab infection. Objective. The objective was to assess the role of prior antibiotic exposure as an independent predictor of MDR-Ab infection in COVID-19 patients admitted to the ICU. Methods. We conducted a retrospective cohort study in 90 patients admitted to the ICU of the Department of Infectology and Geographical Medicine, University Hospital in Bratislava, for respiratory failure due to COVID-19 between 1 September 2021 and 31 January 2022 (delta variant predominance). Patients underwent regular microbial screening. Superinfection was defined as infection occurring ≥48 h after admission. We assessed the role of prior antibiotic exposure and other factors as independent predictors of MDR-Ab isolation. Results. Fifty-eight male and 32 female patients were included in the analysis. Multidrug-resistant bacteria were cultured in 43 patients (47.8%), and MDR-Ab was isolated in 37 patients. Thirty-three (36.7%) patients had superinfection caused by MDR-Ab. Fifty-four (60%) patients were exposed to antibiotics prior to MDR-Ab isolation; of those, 35 (64.8%) patients received ceftriaxone. Prior exposure to ceftriaxone (odds ratio (OR) 4.1; 95% confidence interval (CI) 1.4–11.9; P<0.05), tocilizumab therapy (OR 4.7; 95% CI 1.3–15.0; P< 0.05), and ICU length of stay exceeding 11 days (OR 3.7; 95% CI 1.3–10.3; P< 0.05) were independent predictors of MDR-Ab infection. Conclusions. Prior exposure to ceftriaxone increases the risk of MDR-Ab infection in COVID-19 patients admitted to the ICU. Our findings suggest that antibiotic use in COVID-19 patients admitted to the ICU should be restricted to patients with documented bacterial superinfection. |
| format | Article |
| id | doaj-art-1d34177c90e24e6ab23d7fe9dc638b4f |
| institution | Kabale University |
| issn | 1918-1493 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-1d34177c90e24e6ab23d7fe9dc638b4f2025-02-03T01:29:34ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1918-14932023-01-01202310.1155/2023/4951273Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care UnitP. Mihalov0J. Hodosy1A. Koščálová2M. Čaprnda3M. Kachlíková4J. Jurenka5M. Bendžala6P. Sabaka7Department of Infectology and Geographical MedicineEmergency DepartmentDepartment of Infectology and Geographical Medicine1st Department of Internal MedicineDepartment of Infectology and Geographical MedicineDepartment of Infectology and Geographical MedicineDepartment of Infectology and Geographical MedicineDepartment of Infectology and Geographical MedicineBackground. Multidrug-resistant Acinetobacter (MDR-Ab) is one of the most important pathogens causing superinfections in COVID-19 patients hospitalised in the intensive care unit (ICU). The occurrence of MDR-Ab superinfection significantly impairs the prognosis of patients in the ICU. Overuse of antibiotics in COVID-19 patients might contribute to the risk of developing MDR-Ab infection. Objective. The objective was to assess the role of prior antibiotic exposure as an independent predictor of MDR-Ab infection in COVID-19 patients admitted to the ICU. Methods. We conducted a retrospective cohort study in 90 patients admitted to the ICU of the Department of Infectology and Geographical Medicine, University Hospital in Bratislava, for respiratory failure due to COVID-19 between 1 September 2021 and 31 January 2022 (delta variant predominance). Patients underwent regular microbial screening. Superinfection was defined as infection occurring ≥48 h after admission. We assessed the role of prior antibiotic exposure and other factors as independent predictors of MDR-Ab isolation. Results. Fifty-eight male and 32 female patients were included in the analysis. Multidrug-resistant bacteria were cultured in 43 patients (47.8%), and MDR-Ab was isolated in 37 patients. Thirty-three (36.7%) patients had superinfection caused by MDR-Ab. Fifty-four (60%) patients were exposed to antibiotics prior to MDR-Ab isolation; of those, 35 (64.8%) patients received ceftriaxone. Prior exposure to ceftriaxone (odds ratio (OR) 4.1; 95% confidence interval (CI) 1.4–11.9; P<0.05), tocilizumab therapy (OR 4.7; 95% CI 1.3–15.0; P< 0.05), and ICU length of stay exceeding 11 days (OR 3.7; 95% CI 1.3–10.3; P< 0.05) were independent predictors of MDR-Ab infection. Conclusions. Prior exposure to ceftriaxone increases the risk of MDR-Ab infection in COVID-19 patients admitted to the ICU. Our findings suggest that antibiotic use in COVID-19 patients admitted to the ICU should be restricted to patients with documented bacterial superinfection.http://dx.doi.org/10.1155/2023/4951273 |
| spellingShingle | P. Mihalov J. Hodosy A. Koščálová M. Čaprnda M. Kachlíková J. Jurenka M. Bendžala P. Sabaka Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit |
| title_full | Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit |
| title_fullStr | Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit |
| title_full_unstemmed | Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit |
| title_short | Antimicrobial Therapy as a Risk Factor of Multidrug-Resistant Acinetobacter Infection in COVID-19 Patients Admitted to the Intensive Care Unit |
| title_sort | antimicrobial therapy as a risk factor of multidrug resistant acinetobacter infection in covid 19 patients admitted to the intensive care unit |
| url | http://dx.doi.org/10.1155/2023/4951273 |
| work_keys_str_mv | AT pmihalov antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT jhodosy antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT akoscalova antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT mcaprnda antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT mkachlikova antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT jjurenka antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT mbendzala antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit AT psabaka antimicrobialtherapyasariskfactorofmultidrugresistantacinetobacterinfectionincovid19patientsadmittedtotheintensivecareunit |