Ahmed A Maklad
A relationship between COVID-19 and bacterial infection began to appear in severe cases. Numerous investigations documented the spread of Multi-Drug Resistant (MDR) Klebsiella pneumoniae as a coinfection among severely ill COVID-19 patients.
Subjects and methods: The study was conducted from October 2021 to October 2022 in multi-centers in Alexandria governate, Egypt. This study included 522 patients from Intensive Care Unit (ICU) and inpatient departments in 12 acute care hospitals. Data on demographics, comorbidities, microbiologic results, antimicrobial susceptibility, and outcomes were collected directly from medical health records for hospitalized COVID-19 patients.
Results: Most COVID-19 cases were in the age group over 60 years, representing 56.5% of cases. Recent exposure to antimicrobials was the most common in COVID-19 cases co-infected with K. pneumoniae (99%) followed by invasive devices (95.7%), and a history of previous hospitalization (80%). The most common samples isolate of K.pneumoniae was tracheal aspirate 60.1%. Most K. pneumoniae coinfections (46%) occurred in severe COVID-19 cases. There was a significant difference in mechanical ventilation requirements and recent antibiotic exposure between COVID-19 cases co-infected and non-coinfected with K. pneumoniae (p<0.00001). K. pneumoniae has no sensitivity to almost all antimicrobials but is sensitive to Colistin and Tigercillin.
Conclusion: The elderly and critically ill patients are at high risk for SARS-CoV-2 infection and coinfection with K. pneumoniae. Recent hospitalization and prior antimicrobial exposure are the risk factors for coinfection with K. pneumoniae. An increase in dependence on mechanical ventilation for those co-infected with K. pneumoniae.
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