Secondary multidrug resistant bacterial pneumonia among adult COVID-19 patients: A molecular study

Khalifa, Reham; Ismail, Bothayna; Al-Jahdali, Hani; Alghamdi, Huda; Joharjy, Husam; Eibani, Khalid; Sabour, Randa; Almalki, Fahd; Alfarhan, Saleh; Alatram, Mohammed; Algozi, Mohammed; Aljehani, Abdulilah; Alasmari, Ali

doi:10.21608/mid.2023.181978.1427

	Secondary multidrug resistant bacterial pneumonia among adult COVID-19 patients: A molecular study
Microbes and Infectious Diseases
Article 5, Volume 4, Issue 1, February 2023, Page 11-26 PDF (889.18 K)
Document Type: Original Article
DOI: 10.21608/mid.2023.181978.1427
View on SCiNiTO
Authors
Reham Khalifa ¹; Bothayna Ismail²; Hani Al-Jahdali³; Huda Alghamdi⁴; Husam Joharjy⁵; Khalid Eibani⁶; Randa Sabour⁷; Fahd Almalki³; Saleh Alfarhan³; Mohammed Alatram³; Mohammed Algozi³; Abdulilah Aljehani³; Ali Alasmari⁸
¹Medical Microbiology and Immunology department, Faculty of Medicine, Ain Shams University.
²Clinical Pathology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt.
³Medical Department, King Abdulaziz Hospital, Jeddah, Saudi Arabia
⁴Laboratory Department, King Abdulaziz Hospital, Jeddah, Saudi Arabia
⁵Infection Control Department, King Abdulaziz Hospital, Jeddah, Saudi Arabia
⁶Surgery Department, King Abdulaziz Hospital, Jeddah, Saudi Arabia
⁷Radiology department, Faculty of Medicine, Al Azhar University, Cairo, Egypt.
⁸Jeddah Regional Laboratory, Jeddah, Saudi Arabia
Abstract
Background: Secondary bacterial pneumonia especially with multidrug resistant (MDR) organisms is one of the devastating complications that can worsen COVID-19 patients’ outcomes.The study aimed to evaluate the impact of secondary MDR bacterial pneumonia on COVID-19 patients’ outcomes with molecular detection of genes involved in antimicrobial resistance among isolates of the most prevalent causative pathogen. Methods: Thestudy included 50 critically ill patients with acute severe COVID-19 with evidence of secondary MDR bacterial pneumonia, 50 critically ill patients with acute severe COVID-19 without evidence of secondary bacterial pneumonia, and 30 clinically stable patients with acute moderate COVID-19 infections. Respiratory samples were cultured for identification and antibiotic susceptibility of the causative pathogens. MDR/XDR A. baumannii, the most prevalent pathogen, was screened for multiple antibiotic resistance genes using single-plex and multiplex polymerase chain reactions. Results: Critically ill COVID-19 patients with secondary MDR bacterial pneumonia in group I had a significantly higher mortality rate.MDR/XDR A. baumannii was the most prevalent pathogen (39.2%) isolated with the highest cause specific mortality rate (38%). Multiple resistance genes were detected including 𝑏𝑙𝑎_OXA-51, 𝑏𝑙𝑎_OXA-48, 𝑏𝑙𝑎_OXA-24, 𝑏𝑙𝑎_ADC,𝑏𝑙𝑎_CIT, 𝑏𝑙𝑎_KPC, aacA4, aacC1, acc (6’), aphA1, aph6, and aadA1. Conclusion: Secondary MDR bacterial pneumonia had a significant impact on critically ill COVID-19 patients with a significantly higher mortality rate. Thus, preventing secondary MDR bacterial pneumonia through infection prevention measures, including standard precautions, preventive care bundles and antimicrobial stewardship programs, should be strictly implemented to protect critically ill COVID-19 patients and help avoid its detrimental effect on patients’ outcomes.
Keywords
SARS-CoV-2; COVID-19; Antimicrobial; Resistance; Acinetobacter


Statistics Article View: 497 PDF Download: 272