Multidrug-Resistant Bacteria in a COVID-19 Hospital in Zagreb
Branka Bedenić,
Vesna Bratić,
Slobodan Mihaljević,
Anita Lukić,
Karlo Vidović,
Krešimir Reiner,
Silvia Schöenthaler,
Ivan Barišić,
Gernot Zarfel,
Andrea Grisold
Affiliations
Branka Bedenić
Department for Microbiology and Parasitology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Vesna Bratić
Clinical Department for Anestesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
Slobodan Mihaljević
Clinical Department for Anestesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
Anita Lukić
Varaždin General Hospital, 42000 Varaždin, Croatia
Karlo Vidović
Clinical Department for Anestesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
Krešimir Reiner
Clinical Department for Anestesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
Silvia Schöenthaler
Austrian Institute of Technology, 1210 Vienna, Austria
Ivan Barišić
Austrian Institute of Technology, 1210 Vienna, Austria
Gernot Zarfel
Institute for Hygiene, Microbiology and Environmental Medicine, Medical University Graz, 8010 Graz, Austria
Andrea Grisold
Institute for Hygiene, Microbiology and Environmental Medicine, Medical University Graz, 8010 Graz, Austria
During November to December 2020, a high rate of COVID-19-associated pneumonia with bacterial superinfections due to multidrug-resistant (MDR) pathogens was recorded in a COVID-19 hospital in Zagreb. This study analyzed the causative agents of bacterial superinfections among patients with serious forms of COVID-19. In total, 118 patients were hospitalized in the intensive care unit (ICU) of the COVID-19 hospital. Forty-six out of 118 patients (39%) developed serious bacterial infection (VAP or BSI or both) during their stay in ICU. The total mortality rate was 83/118 (70%). The mortality rate due to bacterial infection or a combination of ARDS with bacterial superinfection was 33% (40/118). Six patients had MDR organisms and 34 had XDR (extensively drug-resistant). The dominant species was Acinetobacter baumannii with all isolates (34) being carbapenem-resistant (CRAB) and positive for carbapenem-hydrolyzing oxacillinases (CHDL). One Escherichia coli causing pneumonia harboured the blaCTX-M-15 gene. It appears that the dominant resistance determinants of causative agents depend on the local epidemiology in the particular COVID center. Acinetobacter baumannii seems to easily spread in overcrowded ICUs. Croatia belongs to the 15 countries in the world with the highest mortality rate among COVID-19 patients, which could be in part attributable to the high prevalence of bacterial infections in local ICUs.
