Bacterial Co-Infection in Patients with Coronavirus: A Rapid Review to Support COVID-19 Antimicrobial Prescription

Abstract

The goal of this study was to determine the most common microorganisms present in COVID-19 patients with co-infections at the General Hospital of Mexicali. Bacterial co-infections have been reported in two previous global pandemics caused by viruses. In a retrospective observational study, we obtained information from 1979 patients. All had symptoms of respiratory disease, and we performed real-time Polymerase Chain Reaction tests on nasopharyngeal swab samples. Of the 1979 patients, 316 were negative; so, they were excluded. One thousand and sixty-three patients had positive results for COVID-19; one hundred and seventy-two (10.34%) had respiratory co-infections. These data were corroborated by positive growth results in culture media and identified using the MALDI-TOF MS System. Vitek 2® Compact, an automated identification system, determined the antimicrobial susceptibility testing results. We analyzed and determined the microorganisms in co-infected patients. Different microorganisms were found, including bacteria and fungi. The most prevalent of all the organisms was Acinetobacter baumannii, which was present in 64 patients (37.2%). We recommend improving the diagnostic and surveillance protocols for possible cases of co-infections in patients with COVID-19. Unlike co-infections in pandemic influenza, the spectrum of microorganisms that cause COVID-19 is too broad and varied to recommend empiric antibiotic therapy.

Keywords

• co-infection
• SARS-CoV-2
• antimicrobial resistance
• empiric antibiotic stewardship