Prevalence and Epidemiological and Clinical Features of Bacterial Infections in a Large Cohort of Patients Hospitalized for COVID-19 in Southern Italy: A Multicenter Study
Lorenzo Onorato,
Federica Calò,
Paolo Maggi,
Enrico Allegorico,
Ivan Gentile,
Vincenzo Sangiovanni,
Vincenzo Esposito,
Chiara Dell’Isola,
Giosuele Calabria,
Raffaella Pisapia,
Angelo Salomone Megna,
Alfonso Masullo,
Elio Manzillo,
Grazia Russo,
Roberto Parrella,
Giuseppina Dell’Aquila,
Michele Gambardella,
Felice Di Perna,
Mariantonietta Pisaturo,
Nicola Coppola
Affiliations
Lorenzo Onorato
Infectious Diseases Section, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Federica Calò
Infectious Diseases Section, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Paolo Maggi
Infectious Disease Unit, A.O. S Anna e S Sebastiano Caserta, 81100 Caserta, Italy
Enrico Allegorico
Emergency Unit, PO Santa Maria delle Grazie, 80078 Pozzuoli, Italy
Ivan Gentile
Infectious Disease Unit, University Federico II, 80138 Naples, Italy
Vincenzo Sangiovanni
Third Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Vincenzo Esposito
IV Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Chiara Dell’Isola
Hepatic Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Giosuele Calabria
IX Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Raffaella Pisapia
First Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Angelo Salomone Megna
Infectious Disease Unit, A.O. San Pio, PO Rummo, 82100 Benevento, Italy
Alfonso Masullo
Infectious Disease Unit, A.O. San Giovanni di Dio e Ruggi D’Aragona Salerno, 84131 Salerno, Italy
Elio Manzillo
VIII Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Grazia Russo
Infectious Disease Unit, Ospedale Maria S.S. Addolorata di Eboli, ASL Salerno, 84131 Salerno, Italy
Roberto Parrella
Respiratory Infectious Diseases Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Giuseppina Dell’Aquila
Infectiou Disease Unit, A.O. Avellino, 83100 Avellino, Italy
Michele Gambardella
Infectious Disease Unit, P.O. S. Luca, ASL Salerno, 84078 Vallo della Lucania, Italy
Felice Di Perna
Pneumology Unit, AORN Caserta, 81100 Caserta, Italy
Mariantonietta Pisaturo
Infectious Diseases Section, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Nicola Coppola
Infectious Diseases Section, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Background: The aim of this study was to evaluate the prevalence of bacterial infections and antimicrobial prescriptions in a large cohort of COVID-19 patients and to identify the independent predictors of infection and antibiotic prescription. Methods: All consecutive patients hospitalized for COVID-19 from March 2020 to May 2021 at 1 of the 17 centers participating in the study were included. All subjects showing a clinical presentation consistent with a bacterial infection with microbiological confirmation (documented infection), and/or a procalcitonin value >1 ng/mL (suspected infection) were considered as having a coinfection (if present at admission) or a superinfection (if acquired after at least 48 h of hospital stay). Results: During the study period, of the 1993 patients, 42 (2.1%) presented with a microbiologically documented infection, including 17 coinfections and 25 superinfections, and 267 (13.2%) a suspected infection. A total of 478 subjects (24.5%) received an antibacterial treatment other than macrolides. No independent predictors of confirmed or suspected bacterial infection were identified. On the contrary, being hospitalized during the second wave of the pandemic (OR 1.35, 95% CI 1.18–1.97, p = 0.001), having a SOFA score ≥3 (OR 2.05, 95% CI 1.53–2.75, p p p = 0.023) were all independently related to having received an antimicrobial prescription. Conclusions: Our study reported a high rate of antimicrobial prescriptions despite a limited number of documented or suspected bacterial infections among the large cohort of hospitalized COVID-19 patients.
