Pattern of Bacterial and Fungal Infections among Hospitalized Patients with COVID-19 versus non COVID-19 Community Acquired Pneumonia

Abstract

Background: It is strongly believed that co-infections play an important role during COVID-19 outbreak. Furthermore, secondary bacterial pneumonia rates increase rapidly in intensive care unit patients. Objectives: This study aimed to elucidate the rate of bacterial and fungal contagions among the hospitalized COVID-19 patients and compares it with non-COVID-19 community acquired pneumonia (CAP) cases with documentation of the most common organisms to guarantee the responsible use of antibiotics among these cases. Methodology: 100 patients were admitted with confirmed CAP and classified into 2 groups according to SARS-CoV-2 PCR results; the first group consisted of 52 COVID-19 positive patients. The second group included 48 patients with non-COVID-19 CAP. Results: COVID-19 group showed several negative sputum cultures than the non-COVID-19 group (p=0.023). Within the cases with positive cultures, COVID-19 patients had more (Staph. aureus, E. coli, Klebsiella pneumoniae and Candida albicans). While non-COVID-19 patients had more (Streptococcus, Pseudomonas aeruginosa, Enterococcus and Proteus) (p <0.05). COVID-19 cases had further resistant strains (p =0.031). Regarding the outcome findings, there were considerable increase in duration of the hospital stay (LHS), necessity of oxygen support and mechanical ventilation among COVID-19 group [p <0.05] with a higher decease rate among COVID-19 group. Conclusions: Critically ill COVID-19 patients exhibited a higher rate of bacterial co-infection detected in sputum (80.8%), PSI, LHS, necessity for oxygen, mechanical ventilation and mortality were higher in COVID-19 CAP compared with non-COVID-19 CAP PSI, LHS, necessity for oxygen, mechanical ventilation and decease rate which were higher among COVID-19 cases compared with non-COVID-19 CAP.