The Impact of Secondary Catheter-Related Bloodstream Infection on the Course of COVID-19 Infection

Abstract

Secondary bacterial infections can worsen the prognosis for COVID-19, especially in patients with severe infections. Thus, we aim to investigate the effect of secondary catheter-related bloodstream infections on the course of COVID-19 infection. This is a retrospective, nested case-control study and included 236 confirmed COVID-19 infection hospitalized patients, divided into 2 groups (COVID-19, n = 64; non–COVID-19, n = 172) according to SARS-CoV-2 RT-PCR results. The age, sex, and prevalence of chronic diseases were similar in both groups. Klebsiella pneumoniae (31.2%) and Acinetobacter baumannii (21.9%) were the predominant microorganisms in the COVID-19 group. Only A. baumannii was statistically higher in the COVID-19 group (P = 0.046). There were no significant differences in terms of resistance profiles. The 30-day mortality was significantly higher in the COVID-19 group (56.3%) than in the non–COVID-19 group (38.4%) (P = 0.014). There was no significant difference in the length of stay between the 2 groups. The multiple logistic regression analysis of risk factors for 30-day mortality revealed that COVID-19 positivity (odds ratio [OR], 2.167; 95% confidence interval [CI], 1.056–4.446; P = 0.035), infection with extensively drug-resistant bacteria (OR, 2.949; 95% CI, 1.311–6.636; P = 0.009), and infection with pandrug-resistant bacteria (OR, 3.601; 95% CI, 1.213–10.689; P = 0.021) were independent risk factors for 30-day mortality. As a conclusion, this study demonstrated that COVID-19 positivity is an independent risk factor for 30-day mortality of secondary catheter-related bloodstream infections. Gram-negative bacteria were the predominant microorganisms, with A. baumannii being statistically higher in the COVID-19 group compared with the non–COVID-19 group. However, there were no statistically significant differences in terms of the resistance profile of microorganisms.