Antibiotics (Jun 2023)

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

DOI
https://doi.org/10.3390/antibiotics12071124
Journal volume & issue
Vol. 12, no. 7
p. 1124

Abstract

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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.

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